Multitarget DNA Test Sensitive for ID'ing Colorectal Cancer
Better sensitivity, worse specificity than fecal immunochemical test for those at average CRC risk
WEDNESDAY, March 19, 2014 (HealthDay News) -- For patients at average risk of colorectal cancer, a multitarget DNA assay has greater sensitivity, but worse specificity than a fecal immunochemical test (FIT), according to a study published online March 19 in the New England Journal of Medicine.
Thomas F. Imperiale, M.D., from the Indiana University School of Medicine in Indianapolis, and colleagues compared a noninvasive, multitarget stool DNA kit with FIT in a cohort of 9,989 individuals at average risk of colorectal cancer. Quantitative molecular assays for KRAS mutations, aberrant NDRG4 and BMP3 methylation, and β-actin, plus a hemoglobin immunoassay were included in the DNA test.
The researchers found that the sensitivity for colorectal cancer detection was 92.3 and 73.8 percent for DNA testing and FIT, respectively (P = 0.002). The corresponding sensitivities for detecting advanced precancerous lesions were 42.4 and 23.8 percent (P < 0.001). For participants with nonadvanced or negative findings, the specificities were 86.6 percent for DNA testing and 94.9 percent for FIT (P < 0.001). The corresponding specificities were 89.8 and 96.4 percent for those with negative results on colonoscopy (P < 0.001).
"In asymptomatic persons at average risk for colorectal cancer, multitarget stool DNA testing detected significantly more cancers than did FIT but had more false positive results," the authors write.
The study was funded by Exact Sciences.