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Related Concept Videos

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Related Experiment Video

Updated: Jan 13, 2026

Evaluation of Colorectal Cancer Risk and Prevalence by Stool DNA Integrity Detection
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Value of Stool-Based Colorectal Cancer Screening: Integrating Real-World Adherence, Detection, and Prevention in a

A Mark Fendrick1, Derek W Ebner2, Michael Dore3

  • 1Division of General Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, MI 48109, USA.

Journal of Clinical Medicine
|January 10, 2026
PubMed
Summary

Next-generation multi-target stool DNA (ng mt-sDNA) screening detects more colorectal cancer (CRC) and precancerous lesions than FIT. Despite higher initial costs, ng mt-sDNA offers long-term savings through improved CRC prevention and early detection.

Keywords:
adherencecolorectal cancercostscreeningsensitivityspecificitystool test

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Area of Science:

  • Oncology
  • Health Economics
  • Screening Technologies

Background:

  • Colorectal cancer (CRC) screening cost analyses often overlook broader program value.
  • Evaluating stool-based tests requires assessing clinical and economic impacts, including cancer outcomes.

Purpose of the Study:

  • To compare the clinical and economic effects of next-generation multi-target stool DNA (ng mt-sDNA) and fecal immunochemical test (FIT) for CRC screening.
  • To assess impacts on cancer detection, precancerous lesion identification, and overall healthcare costs from a US payer perspective.

Main Methods:

  • A cohort-based decision-analytic cost-estimator model was utilized for a single round of screening.
  • Data on clinical assumptions, prevalence, test performance, adherence, and costs were sourced from clinical trials and real-world evidence.
  • The model estimated outcomes over a 10-year period, assuming undiagnosed cancers become symptomatic.

Main Results:

  • ng mt-sDNA screening resulted in higher adherence and detection of more CRC cases (2235 vs. 436) and advanced precancerous lesions compared to FIT.
  • While ng mt-sDNA had higher per-patient screening costs (USD 801 vs. USD 124), it led to lower overall CRC treatment costs (USD 1423 million vs. USD 1474 million).
  • Total costs, including screening and averted CRC treatment, were lower for ng mt-sDNA (USD 1383 million) versus FIT (USD 1427 million).

Conclusions:

  • Higher upfront costs of ng mt-sDNA are offset by significant savings from enhanced CRC prevention and earlier detection.
  • Superior test performance and adherence rates with ng mt-sDNA contribute to its overall cost-effectiveness.
  • ng mt-sDNA represents a valuable tool for improving CRC screening outcomes and reducing long-term healthcare burden.