Stool testing could reduce need for post-polypectomy colonoscopies: 5 things to know

Annual fecal immunochemical test-based surveillance could be as effective as colonoscopies in reducing long-term colorectal cancer incidence and mortality, according to a recent study published in Gastroenterology. The approach could significantly decrease the overall use of colonoscopies.

Here are five things to know about the study:

1. The "Stool-Based Testing for Post-Polypectomy Colorectal Cancer Surveillance Safely Reduces Colonoscopies: The Molecular Stool Testing for Colorectal Cancer Surveillance Study" study was conducted in the Netherlands, involving 3,453 individuals aged 50 to 75. All participants had undergone stool tests and colonoscopies. Among them, 2,226 had a prior polypectomy, 1,003 had previous colorectal cancer and 224 had a familial risk.

2. Before bowel preparation, participants collected samples for a multitarget stool DNA test and two FITs.

3. The accuracy of the tests was calculated for all surveillance indications. For the post-polypectomy indication — the most common and associated with a lower colorectal cancer risk — the long-term impact of stool-based surveillance was evaluated using the adenoma and serrated pathway to CRC model. The study adjusted positivity thresholds for the stool tests to develop strategies that matched or exceeded the effectiveness of colonoscopy surveillance.

4. Effective stool-based post-polypectomy surveillance reduced the number of colonoscopies by up to  41% and required only 5.6 to 9.5 stool tests over a person’s lifetime.

5. While multitarget stool DNA-based surveillance was more costly than colonoscopies, FIT-based surveillance resulted in cost savings.

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