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Updated: Sep 16, 2025
Evaluation of Colorectal Cancer Risk and Prevalence by Stool DNA Integrity Detection
Published on: June 8, 2020
Pragmatic approach to implementation of universal MSI testing for new cases of colorectal cancer
Vitaliy Y Poylin1, Austin Budlong2, Natasha Poylin3
1Division of Gastrointestinal Surgery, Northwestern Medicine, Northwestern University Feinberg School of Medicine, 676 N. St. Clair St., Suite 650, Chicago, IL, 60611, USA. vitaliy.poylin2@nm.org.
Background:
Microsatellite instability testing is used in cases of colorectal cancer to help identify individuals with Lynch syndrome. There is clinical, but not financial case for this testing. Net Present Value (NPV) is a financial tool designed to calculate whenever investment in the new project is financially sound. We hypothesize that investment into uniform testing on all new colorectal cancers will generate profit over time.
Methods:
Financial model was created based on number of patients seen and tested at tertiary medical center.
Results:
Uniform testing will cost $209 per patients (four test at $52.25 per test) and $5,000 is expected to be spent on pathology technician time. In that cohort, 8 out of 200 patients (equal number of males and females) is expected to be identified as having Lynch syndrome. Based on current charges, 5-year NPV is positive at $110,000 and 10-year NPV is positive at $199.663.
Conclusions:
Initial investment into MSI testing on all new cases of colorectal cancer results positive NPV and can help make a case for uniform testing to the hospital.
