Endoscopists' recommendations after a false positive multitarget stool DNA test: results from a multicenter study.

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.