CRC Risk Factors Don’t Affect Predictive Value of Stool Test

TOPLINE:

The predictive value of the multitarget stool DNA (mt-sDNA) test is unaffected by the presence of known colorectal cancer (CRC) risk factors, suggesting it could be used in patients at increased risk for CRC.

METHODOLOGY:

  • Single-center chart review of all referrals for positive mt-sDNA between 2017 and 2021.

  • Calculation of diagnostic colonoscopy adherence rates.

  • Comparison of detection rates for colorectal neoplasia (CRN) in patients with and without known CRC risk factors.

TAKEAWAY:

  • Among 1297 referrals for positive mt-sDNA, 1176 (91%) patients completed a diagnostic colonoscopy.

  • Absence of neoplasia (false-positive mt-sDNA test) was noted in 27% of colonoscopy exams.

  • Identified neoplasia included any CRN (73%), multiple adenomas (34%), sessile serrated polyps (23%), advanced CRN (33%), and CRC (2.5%).

  • One or more CRC risk factors were present in 19% of positive mt-sDNA test referrals.

  • Presence of CRC risk factors did not influence the positive predictive value of the mt-sDNA test.

IN PRACTICE:

“A positive mt-sDNA test predicts a high likelihood of detecting CRN even in patients with a prior history of adenomatous polyps and/or a family history of CRC. Validation of these findings by means of prospective study seems warranted. If substantiated, then performing mt-sDNA in such patients may be reasonable,” the authors report.

SOURCE:

The study was conducted by Kaden R. Narayani and Raj I. Narayani, MD, with Gastrointestinal Associates, PC, Knoxville, Tennessee. It was published online June 27 in the Journal of Clinical Gastroenterology. The study had no specific funding.

LIMITATIONS:

The study’s retrospective design only allowed for the analysis of positive mt-sDNA data and therefore limited reporting to only positive predictive values. The single-center experience may not be generalizable. The findings should be validated in a prospective study.

DISCLOSURES:

The authors have declared no conflicts of interest.

J Clin Gastroenterol. Published online June 27, 2023. Abstract

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