Related Experiment Video
Updated: Jun 14, 2025
07:35
Evaluation of Colorectal Cancer Risk and Prevalence by Stool DNA Integrity Detection
Published on: June 8, 2020
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Stool-Based Testing for Post-Polypectomy Colorectal Cancer Surveillance Safely Reduces Colonoscopies: The MOCCAS
Beatriz Carvalho1, Willemijn de Klaver2, Francine van Wifferen3
1Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Gastroenterology
|September 1, 2024
Summary
Stool tests can safely reduce colonoscopies for colorectal cancer (CRC) surveillance by up to 41%. Fecal immunochemical tests (FITs) offer a cost-effective alternative to colonoscopy, while multitarget stool DNA tests are more expensive.
Area of Science:
- Gastroenterology
- Oncology
- Preventive Medicine
Background:
- Colonoscopy surveillance for colorectal cancer (CRC) presents a significant burden.
- Stool tests offer a potential method to reduce colonoscopies by identifying high-risk individuals.
Purpose of the Study:
- To evaluate the accuracy and impact of stool-based tests for colorectal cancer surveillance.
- To determine if stool tests can safely reduce the need for colonoscopies.
Main Methods:
- Cross-sectional observational study of 3453 individuals aged 50-75.
- Compared multitarget stool DNA tests and fecal immunochemical tests (FITs) against colonoscopy.
- Used the Adenoma and Serrated Pathway to Colorectal Cancer (ASCCA) model for post-polypectomy surveillance simulation.
Main Results:
- Multitarget stool DNA test AUC: 0.72; FIT OC-SENSOR AUC: 0.61; FIT FOB-Gold AUC: 0.59.
- Stool-based strategies reduced colonoscopies by 15%-41% post-polypectomy.
- FIT-based surveillance was cost-saving, while multitarget stool DNA was more costly than colonoscopy.
Conclusions:
- Stool-based post-polypectomy surveillance is safe and effective.
- Strategies can reduce colonoscopies by up to 41%.
- FIT-based surveillance is a cost-effective alternative to colonoscopy.
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