Is the Multitarget Stool DNA Test Just a Better “FIT” for Colorectal Cancer Screening?
Menée à partir de données portant sur 7 190 participants d'une étude de cohorte allemande et menée à partir des données d'une cohorte américaine (20 176 participants), cette étude évalue la performance d'un test ADN fécal multicible par rapport à un test FIT commercial
Both the fecal immunochemical test (FIT) and multitarget stool DNA test (mt-sDNA) are stool-based screening tests for colorectal cancer (CRC) that are reported qualitatively as positive or negative, even though both tests are quantitative, producing a precise value on a continuous scale. The FIT quantifies the globin portion of human hemoglobin in either per milliliter of buffer or per gram of stool, while the mt-sDNA test generates a score from a multivariable algorithm that measures human hemoglobin as well as specific abnormalities in human DNA. For both tests, the threshold (ie, the cut point) determines how the test performs, ie, its sensitivity and specificity. Lowering the threshold increases sensitivity for CRC, advanced precancerous lesions (APLs), or both and would likely decrease specificity, resulting in a higher false-positive rate and more (unnecessary) colonoscopies.
JAMA Internal Medicine , éditorial, 2023