Utility of Stool-Based Tests for Colorectal Cancer Detection: A Comprehensive Review
Abstract
:1. Introduction
2. Current Review
2.1. Screening Strategies for Colorectal Cancer
2.2. Stool-Based Tests
2.2.1. Guaiac-Based Fecal Occult Blood Test (gFOBT)
2.2.2. Fecal Immunochemical Test (FIT)
2.2.3. Other Biomarkers: Multitarget Stool DNA Test (mt-sDNA)
2.3. Use and Abuse of Fecal Occult Blood Test
3. Discussion
4. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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gFOBT | FIT | mt-sDNA | |
---|---|---|---|
Sensitivity | 0.31–0.79 (95% CI, 0.09–1.0) | 0.79 (95% CI, 0.69–0.86) | 0.93 (95% CI, 0.87–1.0) |
Specificity | 0.87–0.98 (95% CI, 0.95–0.99) | 0.94 (95% CI, 0.92–0.95) | 0.84 (95% CI, 0.84–0.86) |
gFOBT | FIT | mt-sDNA |
---|---|---|
Chemical reaction | Immunochemical reaction | Molecular assays for KRAS gene mutations and aberrant methylation of NDRG4, SDC2, and TFPI2 |
Nonspecific for human hemoglobin | Specific for human hemoglobin | Altered DNA and hemoglobin |
Qualitative | Qualitative or quantitative | Qualitative |
Nonspecific for lower intestinal tract | Higher analytical specificity for lower intestinal tract | Lower specificity and high cost |
Lower sensitivity and detection rate for advanced neoplasia | Higher sensitivity for distal lesions and detection rate for advanced neoplasia | The highest sensitivity for proximal and distal colon and detection rate for advanced neoplasia |
Avoid consuming red meat for 3 days prior, refrain from high doses of vitamin C, and consider discontinuing NSAIDs or aspirin treatment | Dietary restrictions or medication modification are not required | No dietary nor pharmacological restrictions |
Larger stool specimen and less population adherence | Single sample collection and greater population adherence | Single sample single collection at home |
Higher rate of false positives and consequent colonoscopy | Lower rate of false positives | Free from false positives solely due to hemoglobin (p.e. intermittent bleeding) |
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Gómez-Molina, R.; Suárez, M.; Martínez, R.; Chilet, M.; Bauça, J.M.; Mateo, J. Utility of Stool-Based Tests for Colorectal Cancer Detection: A Comprehensive Review. Healthcare 2024, 12, 1645. https://doi.org/10.3390/healthcare12161645
Gómez-Molina R, Suárez M, Martínez R, Chilet M, Bauça JM, Mateo J. Utility of Stool-Based Tests for Colorectal Cancer Detection: A Comprehensive Review. Healthcare. 2024; 12(16):1645. https://doi.org/10.3390/healthcare12161645
Chicago/Turabian StyleGómez-Molina, Raquel, Miguel Suárez, Raquel Martínez, Marifina Chilet, Josep Miquel Bauça, and Jorge Mateo. 2024. "Utility of Stool-Based Tests for Colorectal Cancer Detection: A Comprehensive Review" Healthcare 12, no. 16: 1645. https://doi.org/10.3390/healthcare12161645