Abstract IA13: Stool DNA detection of colorectal neoplasia

Stool DNA testing has emerged as a sensitive, noninvasive option for colorectal cancer (CRC) screening. A multi-target stool DNA test (MT-sDNA) has recently become available in the U.S. as the first FDA-approved molecular-based cancer screening test (“Cologuard” (Exact Sciences)). It is also approved by the Centers for Medicare 10:272), stool assay of exfoliated molecular markers proved to be more sensitive than DNA testing on paired plasma for detection of colorectal neoplasia, and differences were most striking with early stage CRC and precancers. Such findings suggest that the mechanism of luminal exfoliation into stool may provide a biological advantage in early detection as it appears to occur sooner in the oncologic cascade than does vascular invasion into the circulation.Average-Risk CRC Screening: The performance of the optimized MT-sDNA test (which assays a panel of 2 methylated genes, mutant KRAS, and hemoglobin) has been evaluated in multiple clinical studies. Case-control studies showed that CRC and precancers at greatest risk for progression could be detected with high sensitivity, that detection was unaffected by tumor stage or site within the colon, and that sensitivity for polyps increased in proportion to lesion size (Gastroenterology 2012;142:248, Clin Gastroenterol Hepatol 2013;11:1313). In subsequent cross-sectional validation studies from the screening setting (NEJM 2014; 370:1287, Mayo Clin Proc 2016;91:61), MT-sDNA achieved sensitivities for CRC of ...
Source: Cancer Research - Category: Cancer & Oncology Authors: Tags: Screening and Early Detection Source Type: research