Postgraduate Course at DDW: Complete Clinical Updates for Today's Practice

1A_GradyPro non-endo tests

Pdf Summary

The document, authored by Dr. William Grady, discusses non-endoscopic testing options for colorectal cancer (CRC) screening. The significance of these stool and blood-based tests lies in their approval by the FDA, effectiveness based on test accuracy, and their potential to improve compliance through offering various testing choices.<br /><br />Non-endoscopic CRC screening tests mentioned include the Fecal Immunochemical Test (FIT), multitarget stool RNA/DNA tests like MT-sRNA (Colosense) and MT-sDNA (Cologuard Plus), cell-free DNA (cfDNA) tests (Shield and PREEMPT CRC trial/BUE-C trial), and Epi proColon. The document underscores that FIT tests have shown significant sensitivity and specificity for detecting CRC and advanced adenomas at varying thresholds. Multitarget stool tests, such as MT-sRNA, offer notable specificity as well, while blood-based tests (BBTs), specifically cfDNA tests, have demonstrated varying sensitivity across different CRC stages and promising specificity for non-advanced neoplasia.<br /><br />The prevalence and impact of non-endoscopic tests are highlighted in multiple studies, pointing to their role in reducing CRC incidence and mortality rates similar to colonoscopy, despite lower compliance rates when compared to stool and blood tests. Compliance rates for different demographics and test types are presented, showing that compliance improves significantly with test choice options, particularly when patients are offered alternatives to colonoscopy.<br /><br />The document advocates for the integration of non-endoscopic tests into CRC screening programs, noting their efficacy and role in improving patient compliance, especially in those who decline colonoscopy. It underscores the imperative of meeting patients’ needs with accessible and varied testing options to potentially decrease CRC mortality and incidence.

Keywords

colorectal cancer

non-endoscopic testing

stool tests

blood-based tests

FDA approval

Fecal Immunochemical Test

multitarget stool RNA/DNA

cell-free DNA tests

patient compliance

CRC screening programs