Stool DNA Test Accurate in Screening for Colorectal Cancer in Alaska Native People

Stool DNA Test Accurate in Screening for Colorectal Cancer in Alaska Native People

By The ASCO Post
Key Points: First- why Alaskans – beside being remote from screening  , they independently have the highest rate of colon cancer and the highest death rate

  • The stool DNA test detected 100% of colorectal cancers.
  • Stool DNA test sensitivity for precancerous polyps increased significantly in proportion to polyp size and the related risk of progression to cancer.
  • Stool DNA testing detected 67% of sessile serrated polyps larger than 1 cm, compared to just 11% by fecal occult blood testing.

Cologuard stool DNA testing for colorectal cancer was found to be an accurate noninvasive screening option for Alaska Native people, a population with one of the world’s highest rates of colorectal cancer, concluded researchers from the Alaska Native Tribal Health Consortium and Mayo Clinic.

The remote residence of many Alaska Native people in sparsely distributed communities across vast, roadless regions creates a barrier to screening with conventional tools, such as a colonoscopy. Stool DNA testing, which was recently approved by the U.S. Food and Drug Administration (FDA), may offer a workable and effective screening method for this population. The research was published by Redwood et al in Mayo Clinic Proceedings.

The stool DNA test is a noninvasive screening tool that identifies characteristic chemical changes in stool that signal the presence of cancer or precancerous polyps. The test, which requires no bowel preparation and no diet or medication restrictions, can be done from home via a mailed sampling kit.

“Stool DNA detects colorectal cancer and highest-risk precancerous polyps with high accuracy, and its application within a screening program could translate into more effective prevention and control of the leading cancer among Alaska Native people,” said David Ahlquist, MD, a study author and co-inventor of the stool DNA test.

Study Details

In the study conducted out of Anchorage, Alaska, 661 Alaska Native participants submitted stool samples prior to a prescheduled screening colonoscopy, which served as the reference standard. Stool DNA testing was performed in separate laboratories by technicians unaware of the clinical source of specimens.

The stool DNA test detected significantly more screen-relevant neoplasms than did the fecal immunochemical test. The stool DNA test detected 100% (10/10) of colorectal cancers. Stool DNA test sensitivity for precancerous polyps increased significantly in proportion to polyp size and the related risk of progression to cancer. Detection was 80% for the largest polyp group (those 3 cm or larger).

For the important subset of patients with the sessile serrated polyp type, which accounts for approximately one-third of all cancers and is typically located on the far side of the colon, differences between stool detection rates were striking, said researchers. Stool DNA testing detected 67% of these polyps larger than 1 cm, compared to just 11% by fecal occult blood testing.

“We were pleased to see the impressive results from this important collaboration,” stated Robert Diasio, MD, Director of the Mayo Clinic Comprehensive Cancer Center. He added, “Colorectal cancer mortality should be entirely preventable with use of effective screening tools. Yet, many Americans remain unscreened because of their reticence to undergo invasive procedures as well as to barriers of inconvenience or limited access. The stool DNA test represents an accurate, patient-friendly, and readily accessible new option that we hope will lead to improved screening participation rates in Alaska and across the country.”

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