Diagnostic Performance of Stool-based Testing for Colorectal Lesions Among Average-risk Individuals: A Real-world Evidence Study

J Clin Gastroenterol. 2025 Apr 1;59(4):350-353. doi: 10.1097/MCG.0000000000002053.

Abstract

Objective: We assessed the real-world performance of stool-based tests (SBTs) for colorectal cancer screening.

Materials and methods: Retrospective review of average-risk individuals with positive SBT for advanced neoplasia (adenocarcinoma, advanced adenoma, and/or advanced serrated lesions) detection at follow-up colonoscopy.

Results: There was no statistical difference in the detection of advanced neoplasia ( P = 0.16) between SBTs [30.7% for multitargeted stool DNA (mt-sDNA) vs 22.8% for fecal immunochemical test]. However, there was a significant difference in the detection of advanced serrated lesions (11.3% for mt-sDNA vs 1.8% for fecal immunochemical test, P < 0.001).

Conclusion: There was no difference between SBTs for advanced neoplasia detection, though mt-sDNA detected significantly more advanced serrated lesions.

MeSH terms

  • Adenocarcinoma* / diagnosis
  • Adenocarcinoma* / pathology
  • Adenoma* / diagnosis
  • Adenoma* / pathology
  • Aged
  • Colonoscopy
  • Colorectal Neoplasms* / diagnosis
  • Colorectal Neoplasms* / pathology
  • DNA, Neoplasm / analysis
  • Early Detection of Cancer* / methods
  • Feces* / chemistry
  • Female
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies

Substances

  • DNA, Neoplasm