Journal: Clinical endoscopy
This publication reviews current and emerging non-invasive strategies for colorectal cancer (CRC) screening, comparing existing options and discussing how they may evolve.
Key points:
- • Fecal immunochemical test (FIT)
- Widely used, non-invasive, simple, and inexpensive.
- Performed annually or biennially.
- Has reasonable sensitivity and is proven to reduce CRC incidence and mortality through early detection.
- • Stool DNA-based tests
- Include multitarget stool DNA assays and DNA methylation tests.
- Show higher sensitivity than FIT for CRC and advanced adenomas.
- Slightly lower specificity and higher cost compared with FIT.
- Typically used at longer intervals (about every 3 years).
- Serve as alternatives for individuals unwilling or unable to undergo colonoscopy.
- • Emerging non-invasive tools
- Liquid biopsy, microRNA assays, microbiome-based tests, and urine tests are under development.
- Aim to improve convenience and patient adherence.
- Liquid biopsy, in particular, may appeal to people reluctant to do stool-based testing.
- • Role of machine learning and metagenomics
- Integration of machine learning with metagenomic sequencing of microbial signatures can help distinguish CRC patients from healthy individuals.
- • Overall perspective
- As these tools mature, they may support more personalized and accessible CRC screening models.
- Improved adherence and early detection could translate into further reductions in CRC-related mortality.