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WEDNESDAY, March 19, 2014 (HealthDay News) -- For patients at average risk of colorectal cancer, a multitarget DNA assay has greater sensitivity, but worse specificity than a fecal immunochemical test (FIT), according to a study published online March 19 in the New England Journal of Medicine.
Thomas F. Imperiale, M.D., from the Indiana University School of Medicine in Indianapolis, and colleagues compared a noninvasive, multitarget stool DNA kit with FIT in a cohort of 9,989 individuals at average risk of colorectal cancer. Quantitative molecular assays for KRAS mutations, aberrant NDRG4 and BMP3 methylation, and β-actin, plus a hemoglobin immunoassay were included in the DNA test.
The researchers found that the sensitivity for colorectal cancer detection was 92.3 and 73.8 percent for DNA testing and FIT, respectively (P = 0.002). The corresponding sensitivities for detecting advanced precancerous lesions were 42.4 and 23.8 percent (P < 0.001). For participants with nonadvanced or negative findings, the specificities were 86.6 percent for DNA testing and 94.9 percent for FIT (P < 0.001). The corresponding specificities were 89.8 and 96.4 percent for those with negative results on colonoscopy (P < 0.001).
"In asymptomatic persons at average risk for colorectal cancer, multitarget stool DNA testing detected significantly more cancers than did FIT but had more false positive results," the authors write.