Lowering fecal immunochemical test positivity threshold vs multitarget stool RNA testing for colorectal cancer screening

• Verfasst von: Niedermaier, Tobias [VerfasserIn]
• Verfasst von: Seum, Teresa [VerfasserIn]
• Verfasst von: Hoffmeister, Michael [VerfasserIn]
• Verfasst von: Brenner, Hermann [VerfasserIn]
• Titel: Lowering fecal immunochemical test positivity threshold vs multitarget stool RNA testing for colorectal cancer screening
• Verf.angabe: Tobias Niedermaier, Teresa Seum, Michael Hoffmeister, Hermann Brenner
• E-Jahr: 2024
• Jahr: June 1, 2004
• Umfang: 2 S.
• Fussnoten: Gesehen am 08.01.2025
• Titel Quelle: Enthalten in: American Medical AssociationThe journal of the American Medical Association
• Ort Quelle: Chicago, Ill. : American Medical Association, 1883
• Jahr Quelle: 2024
• Band/Heft Quelle: 332(2024), 3 vom: Juni, Seite 251-252
• ISSN Quelle: 1538-3598
• DOI: doi:10.1001/jama.2024.9289
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1913852652

Abstract

Fecal immunochemical tests (FITs) for hemoglobin are the most widely used screening tests for colorectal cancer (CRC) globally. However, they have limited sensitivity in detecting early-stage CRC and CRC precursors. In 2023, the CRC-PREVENT study, a blinded, prospective, cross-sectional study that enrolled the target population for CRC screening, demonstrated increased sensitivity for CRC of a multitarget stool RNA (mt-sRNA) test compared with FIT alone (94% vs 78%). The mt-sRNA test incorporated a commercially available FIT (iFOBT OC-Auto; positivity threshold, 20 μg hemoglobin per gram of feces), concentration of 8 RNA transcripts, and participant-reported smoking status. However, this increase in sensitivity came at a substantial loss of specificity for no lesions compared with FIT alone (88% vs 96%). This analysis evaluated whether comparable levels of sensitivity and specificity could be achieved by lowering the FIT positivity threshold, without additional stool RNA testing and smoking assessment.