Masterclass: Colorectal Screening Plus (On-Demand) | September 2025-Behind the Scenes: Stool and Blood in the Fight Against Colon Cancer

Video Transcription

Video Summary

Dr. Payne's presentation reviews noninvasive stool and blood tests for colorectal cancer (CRC) screening. Stool tests include guaiac-based fecal occult blood tests, fecal immunochemical tests (FIT), multi-target stool DNA (mt-sDNA) tests, and emerging multi-target stool RNA tests. Guaiac tests are less used due to dietary restrictions and lower sensitivity. FIT detects human hemoglobin without dietary restrictions and has good cancer sensitivity but low sensitivity for advanced adenomas. mt-sDNA tests detect dysplastic DNA markers, have higher sensitivity for cancer and advanced lesions but more false positives and are recommended every three years for average-risk adults. Multi-target stool RNA tests show promising high cancer sensitivity but are not yet guideline-approved. Blood tests include the older methylated septin-9 and newer cell-free DNA assays; both detect cancer DNA but have poor sensitivity for precancerous lesions, so are second-line options for patients refusing stool tests or colonoscopy. Colonoscopy remains the gold standard, but CT colonography and capsule colonoscopy offer alternatives with limitations. Screening increases reduce CRC mortality, but U.S. screening rates remain below targets; patient choice and adherence are crucial.

Asset Subtitle

Pegah Hosseini Carroll

Keywords

colorectal cancer screening

stool tests

fecal immunochemical test (FIT)

multi-target stool DNA test

blood-based DNA assays