Outcomes and Characteristics Across Age Groups of Patients with Positive MT-sDNA Stool Tests: Data from the New...

Stool testing is a colorectal cancer (CRC) screening option for adults 45 years and older. Our aim was to examine characteristics and outcomes across age groups of patients who underwent colonoscopy following a positive multitarget stool DNA (mt-sDNA) test, compared to older age groups.

We examined several outcomes reflecting both adenomatous and serrated pathways, including: any adenoma, clinically relevant serrated polyps (CRSPs, defined as sessile serrated polyps, traditional serrated adenomas, or hyperplastic polyps ≥ 1 cm) and advanced adenomas (AA, defined as any villous or tubulovillous adenomas, or tubular adenomas > 1 cm). Logistic regression models assessed the association between continuous age and each outcome, adjusting for patient sex and other relevant covariates.

The yield of advanced adenomas and CRSPs were equally high across all age groups, including the youngest group; we found no difference in the yield of AAs (OR = 0.99;95%CI:0.91-1.07) or CRSPs (OR = 0.95%CI:0.88-1.03) with increasing age. In contrast, the odds of any adenoma increased significantly with age (OR = 1.17;95%CI:1.09-1.26).

The yield of clinically significant polyps at colonoscopy following a positive multitarget stool DNA (mt-sDNA) test was similarly high across age groups. These findings suggest that mt-sDNA screening provides comparable clinical benefit across all ages of screening-eligible populations. The consistently high detection of advanced polyps across age groups likely reflects the strong positive predictive value of mt-sDNA testing.