Utilization of a Colorectal Cancer Screening Test Among Individuals With Average Risk

Fisher, Deborah A.; Princic, Nicole; Miller‐Wilson, Lesley‐Ann; Wilson, Kathleen; Fendrick, A. Mark; Limburg, Paul J.

doi:10.1001/jamanetworkopen.2021.22269

Cited by 38 publications

(23 citation statements)

References 22 publications

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“…The current study adds to the literature by including robust population estimates overall and by age groups obtained from a larger clinical database. Other real-world studies have also reported increased utilization of mt-sDNA tests since its availability in the US starting in 2015 ( Finney Rutten et al, 2020 , Fisher et al, 2021 , Limburg et al, 2021 ).…”

Section: Discussionmentioning

confidence: 96%

The impact of multi-target stool DNA testing in clinical practice in the United States: A real-world evidence retrospective study

Miller‐Wilson

Limburg

Helmueller

et al. 2022

Preventive Medicine Reports

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Section: Discussionmentioning

confidence: 96%

The impact of multi-target stool DNA testing in clinical practice in the United States: A real-world evidence retrospective study

Miller‐Wilson

Limburg

Helmueller

et al. 2022

Preventive Medicine Reports

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“…Currently, colonoscopy is the gold standard for CRC detection, but this method is invasive procedure with high risk of complications, which limit its widely application in the clinical setting [ 3 ]. Fecal occult blood test (FOBT) or fecal immunochemical test (FIT) is widely used in the clinical setting due to its low cost and non-invasiveness, whereas the sensitivity and specificity of them alone is relatively low and is affect by many confounders [ 4 , 5 ]. Some tumor biomarkers, such as carcinoembryonic antigen (CEA) and carbohydrate antigen-199 (CA199), are also used to diagnose CRC, but the diagnostic accuracy remain unsatisfactory and they were not recommended for CRC screening in current clinical guideline [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Methylated Septin9 has moderate diagnostic value in colorectal cancer detection in Chinese population: a multicenter study

Zhang

et al. 2022

BMC Gastroenterol

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Background The detection rate of methylated Septin9 (mSEPT9) in colorectal cancer (CRC) is varied greatly across the studies. This study aimed to evaluate the diagnostic ability of mSEPT9 in CRC, and compare the diagnostic efficacy with fecal immunochemical test (FIT). Methods 326 subjects from four centers were prospectively recruited, including 179 CRC and 147 non-CRC subjects. The plasma was collected for mSEPT9 and CEA, AFP, CA125, CA153 and CA199 test, and fecal samples for FIT tests. Sensitivity, specificity and area under the curve (AUC) of receiver operating characteristic curve were calculated to evaluate the diagnostic value of each biomarker. Results The positive rate in mSEPT9 and FIT, and the level of CEA, CA125 and CA199 were significantly higher in CRC compared with non-CRC subjects. The mSEPT9 positive rate was not associated with TNM stage and tumor stage. The sensitivity, specificity and AUC of mSEPT9 in diagnostic CRC were 0.77, 0.88 and 0.82, respectively, while the value in FIT was 0.88, 0.80 and 0.83, respectively. mSEPT9 and FIT have higher AUC value than that of CEA, CA125 and CA199. Combination of both mSEPT9 and FIT positive increased sensitivity and AUC to 0.98 and 0.83, respectively, but the specificity was declined. mSEPT9 has a slightly low sensitivity in diagnosis of colon cancer (0.87) compared with rectal cancer (0.93). Conclusion mSEPT9 demonstrated moderate diagnostic value in CRC detection, which was similar to the FIT but superior to the CEA, CA125 and CA199. Combination of mSEPT9 and FIT further improved diagnostic sensitivity in CRC. Trial registration: ChiCTR2000038319.

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“…Recommended screening methods include colonoscopy as well as stool-based tests, such as the fecal immunochemical test (FIT) and the multitarget-stool DNA (mt-sDNA) test. Use of these stool based tests for initial screening, the mt-sDNA in particular, has increased in the past few years ( 4 ).…”

Section: Introductionmentioning

confidence: 99%

“…Use of these stool based tests for initial screening, the mt-sDNA in particular, has increased in the past few years. (4) Stool tests were developed to detect early stages of CRC as well as precancerous polyps which can then be removed during subsequent colonoscopy, which should be performed for all patients with positive stool tests. Past research has found that patients with either positive FIT or positive mt-sDNA tests are more likely to have polyps found during colonoscopy than those without preceding stool tests.…”

Section: Introductionmentioning

confidence: 99%

Serrated Polyp Yield at Colonoscopy in Patients with Positive FIT, Positive mt-sDNA, and Colonoscopy Only: Data from the New Hampshire Colonoscopy Registry

Anderson

Hisey

Robinson

et al. 2022

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background Stool-based screening with Fecal Immunochemical (FIT) or multi-target-stool DNA (mt-sDNA) tests is associated with increased colonoscopy polyp yield. Mt-sDNA includes methylated markers which improve detection of serrated polyps (SP) versus FIT. We compared SP detection in colonoscopies performed for positive FIT or mt-sDNA tests, as well as in colonoscopies without a preceding stool test, using the New Hampshire Colonoscopy Registry, a comprehensive statewide population-based registry. Methods Across the three groups, we compared the frequency of clinically relevant SPs (CRSPs: sessile SPs, hyperplastic polyps ≥10 mm, and traditional serrated adenomas). We also compared SP size, histology, number and bulk (combined sizes). Results Our sample included 560 mt-sDNA+ (age ± SD 66.5 ± 7.9), 414 FIT+ (66.3 ± 8.8) and 59,438 colonoscopy-only patients (61.7 ± 8.0). Mt-sDNA+ patients were more likely to have a higher yield of CRSPs and CRSP bulk than FIT+ (p < 0.0001) or colonoscopy-only patients (p < 0.0001). More mt-sDNA+ patients had CRSPs without large adenomas or CRCs (17.9% vs 9.9% of FIT+ and 8% of colonoscopy-only patients). After adjusting for synchronous large adenomas, CRCs, and other risk factors, mt-sDNA+ patients were more likely (OR 1.82, 95% CI 1.18 – 2.85) than FIT+ patients to have CRSPs. Conclusions Mt-sDNA+ patients had a higher SP yield than FIT+ or colonoscopy-only patients, particularly in the absence of synchronous large adenomas or CRC. Impact Our results suggest that screening with mt-sDNA tests could improve CRC screening by identifying more patients at increased risk from the serrated pathway.

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Utilization of a Colorectal Cancer Screening Test Among Individuals With Average Risk

Cited by 38 publications

References 22 publications

The impact of multi-target stool DNA testing in clinical practice in the United States: A real-world evidence retrospective study

The impact of multi-target stool DNA testing in clinical practice in the United States: A real-world evidence retrospective study

Methylated Septin9 has moderate diagnostic value in colorectal cancer detection in Chinese population: a multicenter study

Serrated Polyp Yield at Colonoscopy in Patients with Positive FIT, Positive mt-sDNA, and Colonoscopy Only: Data from the New Hampshire Colonoscopy Registry

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