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Area of Science:

  • Gastroenterology
  • Oncology
  • Preventive Medicine

Background:

  • Organized screening programs significantly reduce colorectal cancer (CRC) mortality.
  • The multitarget stool DNA (MT-sDNA) test is an FDA-approved CRC screening tool with good compliance.
  • Current guidelines recommend a 10-year follow-up after a positive MT-sDNA test and negative colonoscopy, but practices vary.

Purpose of the Study:

  • To evaluate the frequency of 10-year follow-up recommendations by endoscopists.
  • To identify factors influencing follow-up interval recommendations after a positive MT-sDNA test and negative colonoscopy.

Main Methods:

  • Retrospective analysis of 515 average-risk patients undergoing colonoscopy after a positive MT-sDNA test.
  • Exclusion criteria included prior colonoscopies, polyps, CRC history, IBD, and suboptimal colonoscopy quality.
  • Logistic regression analyzed predictors of 10-year follow-up recommendations.

Main Results:

  • A 13% false positive rate was observed for the MT-sDNA test.
  • In 68 eligible patients with negative colonoscopy results, 51% received a 10-year follow-up recommendation.
  • Older patients and those with multiple comorbidities were more likely to receive shorter screening intervals (≤5 years).

Conclusions:

  • Less than half of endoscopists adhere to the 10-year follow-up guideline for positive MT-sDNA tests with negative colonoscopies.
  • Patient factors like age and comorbidities influence shorter follow-up intervals, potentially contradicting screening benefits.