2024-04-04 03:01:10
In an effort to improve specificity and reduce the occurrence of false positives, while maintaining or increasing sensitivity, a next generation stool DNA test of multiple targets that includes evaluations of molecular markers and levels of hemoglobin for the detection of Colorectal cancer.
In this prospective study called BLUE-C, Thomas F. Imperiale and collaborators from the Indiana University School of Medicine (USA) evaluated the molecular test in asymptomatic adults aged 40 years or older who were undergoing a colonoscopy detection.
20,176 individuals participated in whom the molecular test was performed and one fecal immunochemistry (FIT). The sensitivity of both for colorectal cancer and the specificity for advanced neoplasiaincluding the precancerous lesions advanced: one or more adenomas o sessile serrated lesions (at least 1 cm), lesions with villous histological characteristics and dysplasia high grade.
Of the total participants, 98 had the pathology, 2,144 had advanced precancerous lesions, 6,973 had non-advanced adenomas and 10,961 had non-neoplastic findings or negative colonoscopy. With the DNA test, the sensitivity for colorectal cancer and advanced precancerous lesions was 93.9% and 43.4% (95% CI), respectively; and the specificity for advanced neoplasia and non-neoplastic findings or negative colonoscopy was 90.6% and 92.7% (95% CI), respectively. With FIT, the sensitivity for colorectal cancer and advanced precancerous lesions was 67.3% and 23.3% (95% CI), respectively; and the specificity for advanced neoplasia and non-neoplastic findings or negative colonoscopy was 94.8% and 95.7% (95% CI), respectively.
In conclusion, the new version of the multi-target stool DNA test showed greater sensitivity in the detection of colorectal cancer and advanced precancerous lesions versus fecal immunochemistry, however, the specificity was lower in advanced neoplasia.
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