Three-year interval appropriate between screening for colorectal cancer

Three years after the first negative multi-target stool DNA test, according to a scientific investigation into the best time to screen for colorectal cancer using non-invasive methods for detecting the disease’s targets in the stool, there were no colorectal malignancies discovered. These findings imply that a three-year gap between testing using this technology is therapeutically reasonable.

Colorectal Cancer

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The findings of this multicenter study, guided by Regenstrief Institute Research Scientist and Indiana University School of Medicine faculty member Thomas F. Imperiale, MD, were ascertained by repeating the multi-target stool DNA test at year three, and test results were affirmed via colonoscopy, the gold standard test for identifying colon cancers.

While no malignancies were discovered throughout the three-year interval, 63 progressed precancerous lesions were discovered among the 591 study participants. The study’s authors point out that while the test is meant to detect cancer and high-risk pre-cancerous polyps rather than non-advanced lesions, those discovered three years ago may have progressed since the prior multi-target stool DNA screening.

This study provides screening age range adults and their clinicians with evidence-based information that they need on multi-target stool DNA screening frequency. However, due to the constraints imposed by the pandemic when individuals and healthcare systems postponed or canceled appointments, the number of participants dwindled over the three years, and further study of the test interval is required. A three-year interval may be the most appropriate, but it is possible that a longer interval may work as well or better.

Thomas F. Imperiale, Research Scientist, Regenstrief Institute

Dr Imperiale’s study of 10,000 patients, published in the New England Journal of Medicine in 2014, found that multi-target stool DNA testing, which involves a single stool sample expelled straight from the body into a container, identifies 92.3% of colon tumors.

The capability of a test to identify disease, known as sensitivity, is the most significant feature of cancer screening tests because the primary aim of these tests is to “rule out” disease, in this case, colon or rectum cancer. The recommended age to start colon cancer screening was lowered from 50 to 45 by national guidelines in 2021.

Colon cancer screening tests like the multi-target stool DNA or the less sensitive annual fecal immunochemical test [FIT] are efficient ways to screen the population, especially those at the low-risk end of the average risk population, which includes most individuals in the younger age range of screening. Using at-home tests encourages those who appreciate their ease of use and lower hassle factor to be screened. And it doesn’t simply benefit the individual, it benefits others who are high risk and are best screened with colonoscopy.”

Thomas F. Imperiale, Research Scientist, Regenstrief Institute

About seven or eight out of ten people who meet the criteria for colorectal cancer screening as indicated by national guidelines are regarded to be at average risk for the disease.

Colon cancer is the third most frequent cancer in the United States, with a high mortality rate in both men and women.

Dr Imperiale is primarily interested in creating and testing screening strategies based on individual risk factors, as well as evaluating diagnostics and therapies. Exact Sciences Corporation, the producer of the multi-target stool DNA screening test, supported both the 2022 and 2014 research on multi-target stool DNA testing.

Source:
Journal reference:

Imperiale, T. F., et al. (2022) Three-Year Interval for the Multi-Target Stool DNA Test for Colorectal Cancer Screening: A Longitudinal Study. Cancer Prevention Research. doi.org/10.1158/1940-6207.CAPR-22-0238.

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