Derek W Ebner, Heather A Johnson, Chris Estes, William K Johnson, Rukaiyya S Khan, Gina Thompson, Joyce Kong, Mark Camardo, Michael Dore, Vahab Vahdat, A Mark Fendrick, Paul J Limburg, John B Kisiel
{"title":"多靶点粪便DNA和粪便免疫化学测试：测试性能的系统回顾和荟萃分析。","authors":"Derek W Ebner, Heather A Johnson, Chris Estes, William K Johnson, Rukaiyya S Khan, Gina Thompson, Joyce Kong, Mark Camardo, Michael Dore, Vahab Vahdat, A Mark Fendrick, Paul J Limburg, John B Kisiel","doi":"10.1016/j.amepre.2025.107654","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Colorectal cancer (CRC) remains a leading cause of cancer death in the United States. Since the latest USPSTF update, additional studies examining the performance of the multi-target stool DNA (mt-sDNA) and the fecal immunochemical test (FIT) have been published. This analysis builds upon the USPSTF analysis by including recent studies on test performance.</p><p><strong>Methods: </strong>PubMed and Embase were searched for manuscripts published between December 4, 2019, and July 9, 2024, using colonoscopy as the reference standard. Double-blinded reviewers screened articles. Primary outcomes were test sensitivity and specificity for CRC, advanced neoplasia (AN), advanced precancerous lesions (APLs), and non-advanced precancerous lesions (NAPLs).</p><p><strong>Results: </strong>Of 4,320 citations screened, 41 new studies were identified. After combining with 14 studies from the previous USPSTF evidence review, 55 studies were analyzed. Forty-one studies reported the performance of FIT alone, ten of mt-sDNA alone, and four reported FIT and mt-sDNA. Of 14 studies evaluating mt-sDNA, two considered the next-generation mt-sDNA test's CRC sensitivity was 93.6% (95% CI:89.0-97.1) for next-generation mt-sDNA and 71.6% (95% CI:64.3-77.9) for FIT. Specificity was 91.6% (95% CI:89.2-93.7) for next-generation mt-sDNA and 96.3% (95% CI:95.4-97.0) for FIT. APL sensitivity was 22.2% (95% CI:20.6-24.0) for FIT and 45.6% (95% CI:40.8-50.4) for next-generation mt-sDNA.</p><p><strong>Discussion: </strong>This meta-analysis revealed that mt-sDNA has high sensitivity for detecting CRC and is more than twice as sensitive than FIT for detecting APL. The lifetime benefit and effectiveness of these tests should be further analyzed.</p>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":" ","pages":"107654"},"PeriodicalIF":4.3000,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Multi-target stool DNA and the Fecal Immunochemical Test: A Systematic Review and Meta-analysis on Test Performances.\",\"authors\":\"Derek W Ebner, Heather A Johnson, Chris Estes, William K Johnson, Rukaiyya S Khan, Gina Thompson, Joyce Kong, Mark Camardo, Michael Dore, Vahab Vahdat, A Mark Fendrick, Paul J Limburg, John B Kisiel\",\"doi\":\"10.1016/j.amepre.2025.107654\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Colorectal cancer (CRC) remains a leading cause of cancer death in the United States. Since the latest USPSTF update, additional studies examining the performance of the multi-target stool DNA (mt-sDNA) and the fecal immunochemical test (FIT) have been published. This analysis builds upon the USPSTF analysis by including recent studies on test performance.</p><p><strong>Methods: </strong>PubMed and Embase were searched for manuscripts published between December 4, 2019, and July 9, 2024, using colonoscopy as the reference standard. Double-blinded reviewers screened articles. Primary outcomes were test sensitivity and specificity for CRC, advanced neoplasia (AN), advanced precancerous lesions (APLs), and non-advanced precancerous lesions (NAPLs).</p><p><strong>Results: </strong>Of 4,320 citations screened, 41 new studies were identified. After combining with 14 studies from the previous USPSTF evidence review, 55 studies were analyzed. Forty-one studies reported the performance of FIT alone, ten of mt-sDNA alone, and four reported FIT and mt-sDNA. Of 14 studies evaluating mt-sDNA, two considered the next-generation mt-sDNA test's CRC sensitivity was 93.6% (95% CI:89.0-97.1) for next-generation mt-sDNA and 71.6% (95% CI:64.3-77.9) for FIT. Specificity was 91.6% (95% CI:89.2-93.7) for next-generation mt-sDNA and 96.3% (95% CI:95.4-97.0) for FIT. APL sensitivity was 22.2% (95% CI:20.6-24.0) for FIT and 45.6% (95% CI:40.8-50.4) for next-generation mt-sDNA.</p><p><strong>Discussion: </strong>This meta-analysis revealed that mt-sDNA has high sensitivity for detecting CRC and is more than twice as sensitive than FIT for detecting APL. The lifetime benefit and effectiveness of these tests should be further analyzed.</p>\",\"PeriodicalId\":50805,\"journal\":{\"name\":\"American Journal of Preventive Medicine\",\"volume\":\" \",\"pages\":\"107654\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2025-05-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Preventive Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.amepre.2025.107654\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"MEDICINE, GENERAL & INTERNAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Preventive Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.amepre.2025.107654","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
Multi-target stool DNA and the Fecal Immunochemical Test: A Systematic Review and Meta-analysis on Test Performances.
Introduction: Colorectal cancer (CRC) remains a leading cause of cancer death in the United States. Since the latest USPSTF update, additional studies examining the performance of the multi-target stool DNA (mt-sDNA) and the fecal immunochemical test (FIT) have been published. This analysis builds upon the USPSTF analysis by including recent studies on test performance.
Methods: PubMed and Embase were searched for manuscripts published between December 4, 2019, and July 9, 2024, using colonoscopy as the reference standard. Double-blinded reviewers screened articles. Primary outcomes were test sensitivity and specificity for CRC, advanced neoplasia (AN), advanced precancerous lesions (APLs), and non-advanced precancerous lesions (NAPLs).
Results: Of 4,320 citations screened, 41 new studies were identified. After combining with 14 studies from the previous USPSTF evidence review, 55 studies were analyzed. Forty-one studies reported the performance of FIT alone, ten of mt-sDNA alone, and four reported FIT and mt-sDNA. Of 14 studies evaluating mt-sDNA, two considered the next-generation mt-sDNA test's CRC sensitivity was 93.6% (95% CI:89.0-97.1) for next-generation mt-sDNA and 71.6% (95% CI:64.3-77.9) for FIT. Specificity was 91.6% (95% CI:89.2-93.7) for next-generation mt-sDNA and 96.3% (95% CI:95.4-97.0) for FIT. APL sensitivity was 22.2% (95% CI:20.6-24.0) for FIT and 45.6% (95% CI:40.8-50.4) for next-generation mt-sDNA.
Discussion: This meta-analysis revealed that mt-sDNA has high sensitivity for detecting CRC and is more than twice as sensitive than FIT for detecting APL. The lifetime benefit and effectiveness of these tests should be further analyzed.
期刊介绍：
The American Journal of Preventive Medicine is the official journal of the American College of Preventive Medicine and the Association for Prevention Teaching and Research. It publishes articles in the areas of prevention research, teaching, practice and policy. Original research is published on interventions aimed at the prevention of chronic and acute disease and the promotion of individual and community health.
Of particular emphasis are papers that address the primary and secondary prevention of important clinical, behavioral and public health issues such as injury and violence, infectious disease, women''s health, smoking, sedentary behaviors and physical activity, nutrition, diabetes, obesity, and substance use disorders. Papers also address educational initiatives aimed at improving the ability of health professionals to provide effective clinical prevention and public health services. Papers on health services research pertinent to prevention and public health are also published. The journal also publishes official policy statements from the two co-sponsoring organizations, review articles, media reviews, and editorials. Finally, the journal periodically publishes supplements and special theme issues devoted to areas of current interest to the prevention community.
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