Fecal DNA Testing Comes of Age

As the technology of fecal DNA testing has advanced, its sensitivity for colorectal cancer has increased. The latest iteration is a combination assay that includes molecular tests for KRAS mutations, aberrant NDRG4 and BMP3 methylation, β-actin, and an immunoassay for hemoglobin (i.e., a fecal immunochemical test, or FIT). Now, investigators have assessed its performance compared with FIT in detecting colorectal cancer in patients undergoing screening colonoscopy.

Of 9989 patients evaluated, 65 (0.7%) had colorectal cancer (60 with stages I–III), and 757 (7.6%) had advanced precancerous lesions (advanced conventional adenomas or large (≥1 cm) sessile serrated polyps). The sensitivity of the fecal DNA assay was 92.3% for cancer overall and 93…