Postgraduate Course at DDW: Complete Clinical Updates for Today's Practice | May 2025-1B_Maratt_Non-Endoscopic Testing for CRC Screening-CON

1B_Maratt_Non-Endoscopic Testing for CRC Screening-CON

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The document outlines key considerations in colorectal cancer (CRC) screening, particularly focusing on non-endoscopic testing methods compared to colonoscopy. Dr. Jennifer K. Maratt highlights various testing strategies for identifying CRC and precancerous lesions in asymptomatic individuals. The goal of CRC screening is to effectively and cost-efficiently identify at-risk individuals while considering patient adherence and preference.<br /><br />Different CRC screening methods, including colonoscopy, fecal immunochemical test (FIT), multitarget-stool DNA (mt-sDNA), and blood-based tests, are compared. The presentation highlights that while colonoscopy is highly effective in CRC identification and prevention, non-endoscopic options like FIT and mt-sDNA offer accessible and less invasive alternatives. However, each has its limitations, such as availability, cost, and patient adherence. <br /><br />Recent studies, including those by Chung et al. and Castells et al., provide data on the effectiveness of these methods. For instance, the research indicates that annual FIT can reduce CRC incidence by 72% and CRC mortality by 76%, while colonoscopy performed every ten years results in a 79% reduction in incidence and an 81% reduction in mortality. Blood-based tests present a less invasive option but with significantly lower reductions in CRC incidence and mortality.<br /><br />The document emphasizes that the choice of screening test should align with the setting, resources available, and patient values and preferences. Though colonoscopy is favored for its comprehensive nature, allowing for the identification and removal of precancerous lesions in a single step, non-endoscopic tests are valuable where resources are limited or patient compliance is an issue. Overall, the selection of the best CRC screening test is contingent upon individual circumstances and strategic priorities in healthcare provision.

Keywords

colorectal cancer

CRC screening

non-endoscopic testing

colonoscopy

fecal immunochemical test

multitarget-stool DNA

blood-based tests

patient adherence

screening strategies

precancerous lesions