The stool DNA test: an emerging technology in colorectal cancer screening

The stool DNA test is considered an emerging technology in screening for colorectal cancer. The stool DNA test detects DNA markers which are shed from cells of premalignant adenomas and cancers into the stool. Potentially, both preclinical and clinical colorectal cancer may be detected. Panels of multiple DNA markers are used to ensure a high sensitivity for colorectal cancer. In this article, several advantages of the stool DNA test (compared with current colorectal cancer screening methods) are discussed. The stool DNA test may be more patient-friendly and has a higher degree of sensitivity and specificity for colorectal cancer. No bowel or dietary preparation is required and the test is noninvasive. The stool DNA test screens the entire colon and may detect some other types of cancers proximal to the colon. In the future, there may be potential to use the stool DNA test to screen for aerodigestive cancers (lung, esophageal, gastric, and pancreatic), in addition to colorectal cancer. An improved noninvasive screening test would help allocate colonoscopy resources to those patients who would benefit the most. Colorectal cancer screening cost-effectiveness may also be improved. Some limitations of the stool DNA test include the need for clinical studies in average-risk populations and marker refinement. An automated testing system may help reduce costs and turnaround times. Despite recognized limitations, the stool DNA test is a promising new diagnostic tool with the potential to improve effectiveness of colorectal cancer screening.