Multitarget stool DNA testing for the prevention of colon cancer: outcomes in a large integrated healthcare system
| Autor: | Nadia Huq, Nimish Vakil, Maharaj Singh, Kristin Ciezki |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Electronic data capture Colorectal cancer MEDLINE Colonoscopy Cohort Studies 03 medical and health sciences Feces 0302 clinical medicine Internal medicine medicine Outpatient clinic Humans Radiology Nuclear Medicine and imaging Stool dna Early Detection of Cancer medicine.diagnostic_test business.industry Delivery of Health Care Integrated Gastroenterology DNA Neoplasm medicine.disease Test (assessment) 030220 oncology & carcinogenesis Colonic Neoplasms 030211 gastroenterology & hepatology business Colorectal Neoplasms Cohort study |
| Zdroj: | Gastrointestinal endoscopy. 92(2) |
| ISSN: | 1097-6779 |
| Popis: | Multitarget stool DNA (MT-sDNA) testing is used in primary care as a screening test for colon cancer. Test effectiveness and patient compliance were examined in clinical practice.We assessed outcomes of MT-sDNA testing in a cohort study conducted in a large integrated healthcare system comprising 15 hospitals and 150 outpatient clinics using advanced electronic data capture (Clarity2 [Epic, Verona, Wisc, USA] and REDCap [Encinitas, Calif, USA]) followed by manual chart review to confirm MT-sDNA test results and to monitor the outcomes of subsequent colonoscopy.A total of 6835 MT-sDNA tests were performed over 1 year between 2017 and 2018. Of 1242 patients (18%) who tested positive, 1109 (89%) were referred for colonoscopy, and 905 of them (73%) underwent colonoscopy. Eleven patients (1%) with a positive test had colorectal cancer, 215 (17%) had advanced adenomas, 110 (9%) had serrated adenomas, and 546 (60%) patients had an adenoma. Of the 6835 patients tested, adenoma or cancer was found in 557 patients (8%). An advanced adenoma or cancer was found in 226 of 1242 patients with a positive test (18%). Nonadherence with colonoscopy after a positive test was high (21%), and the cost to detect 1 advanced adenoma or cancer was $38,849.The frequency of adenoma detection by an MT-sDNA screening strategy is low, and many positive tests are not associated with significant findings at colonoscopy. Failure to follow a positive test with colonoscopy is a significant problem that needs to be considered when this screening strategy is adopted. |
| Databáze: | OpenAIRE |
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