The use of multi-target stool DNA (mt-sDNA) as an interval test for post-colonoscopy colorectal cancers had a high positive predictive value (PPV) and warrants further study, according to results published in Clinical and Translational Gastroenterology.

The PPV of mt-sDNA for the endpoints of any colorectal neoplasia, advanced adenoma, right-sided neoplasia, sessile serrated polyps, and colorectal cancer were assessed using a retrospective cohort. A total of 850 patients with positive mt-sDNA after a previous negative colonoscopy were included.

Overall, colorectal neoplasia was found in 535 patients with positive mt-sDNA (PPV, 63%). Among 107 average-risk patients undergoing early screening (0-9 years after previous screening) with mt-sDNA, any colorectal neoplasia was detected in 67 patients (PPV, 63%), advanced colorectal neoplasia in 16 patients (PPV, 15%), and right-sided neoplasia in 48 patients (PPV, 46%).

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Comparisons of these neoplasia endpoints with average-risk patients whose previous colonoscopy was inadequate for colorectal cancer screening revealed no significant differences. There was a greater detection of neoplasia in those at increased risk undergoing surveillance vs those at high-risk with a previous incomplete examination (P =.05).

This study was limited by its retrospective design, leading to a lack of control regarding which patients and providers opted for early screening or used mt-sDNA for surveillance. Additionally, certain markers of colonoscopy quality were not recorded in initial reports.

According to investigators, these results suggest, “that lesions were likely missed on previous examination or may have arisen de novo.” They concluded that, “prospective studies to evaluate mt-sDNA as an interval test between screening colonoscopies are warranted.”

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures. 


Ebner DW, Eckmann JD, Burger KN, et al. Detection of postcolonoscopy colorectal neoplasia by multi-target stool DNA. Clin Transl Gastroenterol. 2021;12(6):e00375. doi: 10.14309/ctg.0000000000000375

This article originally appeared on Gastroenterology Advisor