Журнал канцерогенеза и мутагенеза

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Colorectal Cancer Screening: Is there a Role for Stool DNA Testing?

Laura Mazilu, Andra-Iulia Suceveanu, Irinel-Raluca Parepa and Doina-Ecaterina Tofolean

Colorectal cancer (CRC) is a major cause of morbidity and mortality throughout the world, being the third most common cancer in the world and the fourth most common cause of death. In recent years increased rates of CCR incidence has been reported in developing countries. The presence or absence of screening programs is an important factor in determining overall changes of CRC epidemiology. CCR screening modalities vary throughout the world, and the differences are probably due to the cost and availability of diagnostic resources. Colonoscopy, sigmoidoscopy, and FOBTs are all recommended screening tests, but adherence rates are low. Additional stoolbased methods that offer more options for CRC have been developed, including fecal DNA tests. Stool-based DNA testing is noninvasive, and it is more sensitive and specific than FOBTs, only a single stool sample is needed, the test does not require diet or medication restrictions, and it evaluates the whole colon and rectum. The disadvantages of stool-based DNA testing include: high cost, lower sensitivity comparing with colonoscopy, and the fact that if the stool-based test is positive, colonoscopy needs to be done anyway. Finally, relatively high rates of false-positive and false-negative results limit the accuracy of these tests, thereby restricting their widespread use.