Multi-Target Stool DNA Testing for Colorectal Cancer Screening: Emerging Learning on Real-world Performance

Area of Science:

• Oncology
• Gastroenterology
• Preventive Medicine

Background:

• Multi-target stool DNA (MT-sDNA) testing was approved in 2014 for colorectal cancer (CRC) screening in average-risk individuals.
• Recent post-market studies offer insights into its real-world clinical utility beyond pre-approval data.

Purpose of the Study:

• To review recent literature on the clinical use and utility of MT-sDNA testing for CRC screening.
• To provide an updated perspective based on post-market observational data.

Main Methods:

• Literature review of post-market studies on MT-sDNA testing for CRC screening.
• Analysis of clinical practice trends and patient outcomes.

Main Results:

• MT-sDNA is incorporated into major guidelines and shows increasing clinical adoption.
• High adherence to follow-up colonoscopy after positive MT-sDNA tests.
• Approximately two-thirds of patients with positive tests have colorectal neoplasia (CRN), with 1 in 3 having advanced CRN.
• High yield of CRN attributed to increased screening probability and potentially enhanced endoscopist attention.
• Negative colonoscopy after positive MT-sDNA test requires no further intervention.

Conclusions:

• MT-sDNA testing is a valuable tool for enhancing CRC screening rates and quality.
• Further research needed on MT-sDNA performance in high-risk populations and as an interval test post-colonoscopy.