Noninvasive fecal testing for colorectal cancer

Area of Science:

• Oncology
• Gastroenterology
• Biomarker Discovery

Background:

• Colorectal cancer (CRC) is a leading global malignancy, necessitating effective diagnostic strategies.
• Stool-based biomarkers offer a non-invasive approach to CRC detection and screening.

Purpose of the Study:

• To review the current utility of stool diagnostic biomarkers for colorectal cancer (CRC).
• To compare the performance of established and emerging stool tests for CRC detection.

Main Methods:

• Literature review of stool-related tests and biomarker candidates for CRC diagnosis.
• Analysis of guaiac-based fecal occult blood test (gFOBT), fecal immunochemical test (FIT), and multitarget stool DNA test (MT-sDNA).
• Evaluation of emerging biomarkers including microRNAs, protein markers, and microbiota.

Main Results:

• MT-sDNA demonstrates high sensitivity (87.0-100%) for CRC and (32.7-82.0%) for advanced adenomas.
• Fecal microRNAs, protein markers, and microbiota show variable sensitivity and specificity for CRC and advanced adenomas.
• MT-sDNA exhibits higher sensitivity for CRC and advanced precancerous lesions compared to FIT.

Conclusions:

• MT-sDNA is a highly sensitive stool biomarker test for colorectal cancer (CRC) and advanced adenomas.
• Despite its sensitivity, MT-sDNA has a high detection cost.
• Annual FIT may be a more effective initial non-invasive screening strategy for CRC compared to triennial MT-sDNA.