Colorectal Cancer Screening: Stool DNA and Other Noninvasive Modalities

Abstract

Colorectal cancer screening dates to the discovery of pre-cancerous adenomatous tissue. Screening modalities and guidelines directed at prevention and early detection have evolved and resulted in a significant decrease in the prevalence and mortality of colorectal cancer via direct visualization or using specific markers. Despite continued efforts and an overall reduction in deaths attributed to colorectal cancer over the last 25 years, colorectal cancer remains one of the most common causes of malignancy-associated deaths. In attempt to further reduce the prevalence of colorectal cancer and associated deaths, continued improvement in screening quality and adherence remains key. Noninvasive screening modalities are actively being explored. Identification of specific genetic alterations in the adenoma-cancer sequence allow for the study and development of noninvasive screening modalities beyond guaiac-based fecal occult blood testing which target specific alterations or a panel of alterations. The stool DNA test is the first noninvasive screening tool that targets both human hemoglobin and specific genetic alterations. In this review we discuss stool DNA and other commercially available noninvasive colorectal cancer screening modalities in addition to other targets which previously have been or are currently under study.

Colonoscopy Findings in Patients Who Have Positive Fecal Occult Blood Test for Colorectal Cancer Screening

“…KRK taraması için birçok ülke yaygın olarak GGK, rektosigmoidoskopi ve kolonoskopi kullansa da, kapsül endoskopi ve sanal kolonoskopi gibi kolonu anatomik olarak inceleyen yöntemler veya deneysel aşamada olan plazmada veya gaytada çeşitli DNA ve mikroRNA moleküllerinin araştırılmasına dayanan bazı testlerle ilgili yoğun çalışmalar yapılmaktadır (Tablo 2). 9,10,11,12 Bu testlerin hangisi ya da hangilerinin kullanılacağı ile ilgili standart bir öneri yoktur. Ülkeler kanser görülme sıklığı, tarama yapacak iş gücü, ülkenin ekonomik durumu gibi bazı faktörlere bağlı olarak farklı tarama stratejileri uygulayabilmektedir.…”

TSPAN8 and LGALS4 combination as blood biomarkers for colorectal cancer detection

“…Screening reduces mortality by 15-25%, but the hope is to improve these figures. As far as FIT is concerned, a new study proposed an improvement of the FIT increasing the cut-off level of detected hemoglobin and decreasing the times of screening [13] , while the introduction of sDNA tests focused on the possibility of the early detection of precancerous lesions [5,14,15,16] .…”

Discrimination of healthy and colorectal cancer patients using FTIR and PLS-DA

“…In this sense, preventive actions are of great importance for the improvement of disease outcomes as well as reducing the mortality. Routine laboratory tests, such as fecal occult blood, have shown good results in reducing mortality associated with this disease (BAILEY;AGGARWAL;IMPERIALE, 2016;BÉNARD et al, 2018;HARDCASTLE et al, 1996;MANDEL et al, 1993;VENTURA et al, 2014).…”

“…Guaiac-based fecal occult blood test is simple and cost-effective, but has limited sensitivity. Fecal immunochemical test has a higher sensitivity than the guaiac-based test, but is more expensive (BAILEY; AGGARWAL; IMPERIALE, 2016;BÉNARD et al, 2018;STRUM, 2016). Colonoscopy has high sensitivity and allows examination of the entire colon and removal of polyps; however, it requires bowel preparation and sedation, which decreases patients' acceptability of the exam, and can be expensive (STRUM, 2016;SVENSSON et al, 2002;USSUI, 2010;USSUI et al, 2013).…”