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Internal Medicine

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Next-Generation Multitarget Stool DNA Test for Colorectal Cancer Screening | NEJM

In a study comparing screening methods, the next-generation multitarget stool DNA test exhibited superior sensitivity for detecting colorectal cancer (93.9%) and advanced precancerous lesions (43.4%) compared to FIT. However, it demonstrated slightly lower specificity for advanced neoplasia at 90.6%. This indicates that the stool DNA test could significantly enhance early detection of colorectal cancer and precancerous conditions, offering a promising alternative to traditional fecal immunochemical test with improved performance characteristics, though at the expense of some specificity.

  • Sensitivity was 94% for colorectal cancer and 43% for advanced precancerous lesions.

  • Specificity (the proportion of people without cancer or advanced precancerous lesions whose test was negative) was 91%.

  • Positive predictive value (the proportion of positive tests that were true positives for cancer or advanced neoplasia) was 11%.

  • Negative predictive value (the proportion of negative tests that were true negatives for cancer or advanced neoplasia) was 93%.

  • The stool DNA test was substantially more sensitive than FIT (94% vs. 67% for cancer; 43% vs. 23% for advanced precancerous lesions), but slightly less specific.

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