Next-Generation Multitarget Stool DNA vs Fecal Immunochemical Test in 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
Fecal immunochemical tests (FITs) are the most widely used noninvasive colorectal cancer (CRC) screening tests.1 In 2014, a US/Canadian screening study reported higher sensitivity of a multitarget stool DNA test (MSDT), which combined fecal hemoglobin measurement with molecular DNA markers, compared with a commercial FIT. However, this increase in sensitivity was accompanied by a substantial loss of specificity.2 Despite 20-fold higher per-sample costs, use of MSDT-based screening strongly increased in the US in recent years.3 Recently, Imperiale et al4 evaluated diagnostic performance of a next-generation MSDT (NG-MSDT) in another screening colonoscopy cohort (BLUE-C study). Sensitivity was higher than that of a commercial FIT, although again specificity was lower. It was previously shown that lowering the positivity threshold of a commercial quantitative FIT could enhance diagnostic performance to be comparable to a multitarget stool ribonucleic acid (RNA) test,5 prompting an evaluation of whether the same approach could yield similar outcomes with the NG-MSDT.
JAMA Internal Medicine , article en libre accès, 2023