Health
Performance of cfDNA blood-based testing for colorectal cancer screening
The ECLIPSE study reported: New England Medical Journal—Chung et al. compared to colonoscopy, blood-based cell-free DNA (cfDNA) testing is more sensitive for colorectal cancer and more sensitive for advanced neoplasms in colorectal cancer screening. We found that it has high specificity.
Research details
The U.S. multicenter study enrolled 7,861 people eligible for colorectal cancer screening with colonoscopy and cfDNA screening results enrolled from October 2019 to September 2022. It was included. Eligible participants were between 45 and 84 years old and at average risk for colorectal cancer. Co-primary endpoints were the sensitivity of cfDNA testing for colorectal cancer and specificity for advanced neoplasms (colorectal cancer or advanced precancerous lesions) compared with screening colonoscopy. The secondary endpoint was sensitivity to detect advanced precancerous lesions.
cfDNA test performance
Of the 7,861 participants, 65 had colorectal cancer detected by colonoscopy. 1,116 people had advanced precancerous lesions. 2,166 people had non-advanced adenomas. 4,514 people had negative results for colorectal tumors.
A total of 83.1% of participants with colorectal cancer detected by colonoscopy had a positive cfDNA test and 16.9% had a negative test, and the sensitivity of cfDNA in detecting colorectal cancer was 83.1% (95% confidence interval ) was. [CI] = 72.2% – 90.3%). The test has a sensitivity of 87.5% (95% CI = 75.3% to 94.1%) for stage I, II, or III colorectal cancer and 13.2% (95% CI = 11.3) for advanced precancerous lesions. % to 15.3%).
A total of 89.6% of participants whose advanced colorectal tumors were not detected by colonoscopy had a negative cfDNA test, 10.4% had a positive cfDNA test, and the specificity of the cfDNA test for advanced tumors was 89.6% (95% CI = 88.8%-90.3). %).
The specificity of the test for negative results for colorectal tumors on colonoscopy was 89.9% (95% CI = 89.0% to 90.7%).
The researchers concluded, “In an average-risk screening population, the sensitivity of this cfDNA blood-based test was 83% for colorectal cancer, 90% for advanced neoplasms, and 90% for advanced precancerous lesions. showed a sensitivity of 13%.”
Dr. William M. GradyOf the departments of public health, translational science and TherapeuticsFred Hutchinson Cancer Center in Seattle, is the corresponding author on this paper. New England Medical Journal article.
Disclosure: This study was funded by Guardant Health. For full study author disclosure, please visit: nejm.org.
The content of this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas or opinions of ASCO®.
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