RNA Test Outperforms the Fecal Immunochemical Test for Detection of Colorectal Cancer

[bennevisplace]

In the United States, colorectal cancer (CRC) is the second most common cause of cancer deaths when numbers for men and women are combined. It's expected to cause about 52,550 deaths during 2023 cancer.org/cancer/types/col...

As CLL patients, we carry a greater risk of developing a second cancer than do our age-equivalents in the general population; and among the ones we tend to get more often are gastrointestinal cancers lls.org/leukemia/chronic-ly... which include CRC. So a step forward in the quality of screening for CRC should be of interest to us all.

insideprecisionmedicine.com... gives a readable account of a noninvasive, multitarget stool RNA test called ColoSense, showing significant improvements in sensitivity compared with the standard fecal immunochemical test (FIT), and similar or better results than the Cologuard test, in a Phase III trial led by the Washington University School of Medicine.

ColoSense, developed by U.S. biotech Geneoscopy, was able to accurately detect colorectal cancer and advanced adenomas in 94% and 46% of stool samples, respectively, compared with a sensitivity of 78% and 29% for the FIT test.

The ColoSense test did have a higher rate of false positives than the FIT test with a specificity rate of 88% vs 96%, respectively, although this rate was still well above the acceptable FDA minimum of 80%.

Study Results from jamanetwork.com/journals/ja... (Abstract)

The mean (range) age of participants was 55 (45-90) years, with 4% self-identified as Asian, 11% as Black, and 7% as Hispanic. Of the 8920 eligible participants, 36 (0.40%) had colorectal cancer and 606 (6.8%) had advanced adenomas. The mt-sRNA test sensitivity for detecting colorectal cancer was 94%, sensitivity for detecting advanced adenomas was 46%, and specificity for no lesions on colonoscopy was 88%. The mt-sRNA test showed significant improvement in sensitivity for colorectal cancer (94% vs 78%; McNemar P = .01) and advanced adenomas (46% vs 29%; McNemar P < .001) compared with results of the FIT.

The above link is to the full article published in Jama.