Cancer Data Trends 2024: Colorectal Cancer

Publish date: March 15, 2024

Colorectal cancer (CRC) is frequently diagnosed in patients who have a positive fecal immunochemical test (FIT), leading to a significant concern regarding missed colonoscopies.
Although factors like scheduling conflicts and a lack of transportation prevent some veterans from undergoing colonoscopies, a recent analysis showed the most common reason is that patients simply chose not to follow up. Interventions are needed to reverse patient hesitancy to increase colonoscopy completion following a positive FIT.
Delay in undergoing a colonoscopy after a positive FIT is associated with a higher risk of CRC death and late-stage CRC. Interventions to improve CRC outcomes should prioritize scheduling a colonoscopy within 1 year of an abnormal FIT result.
Patient navigators improved completion rates of colonoscopy after a positive FIT, while also reducing the time to schedule the procedure and the number of missed appointments. This intervention presents the potential to help mitigate delayed or missed colonoscopies after a positive FIT.
Several stool-based tests (multitarget DNA and RNA) are being tested with improved sensitivity and specificity compared to current screening methods. Liquid biopsy, or blood-based testing, is also under development. These less invasive screening methods should increase access to CRC screening.
^{mt-sDNA, multitarget stool DNA; mt-sRNA, multitarget stool RNA}
The SIGNAL-C blood screening test uses a combination of circulating tumor DNA (ctDNA) methylation and fragmentation with single targeted sequencing analysis and advanced computational biology and machine learning algorithms.

References

1. May FP, Yano EM, Provenzale D, et al. Barriers to follow-up colonoscopies for patients with positive results from fecal immunochemical tests during colorectal cancer screening. Clin Gastroenterol Hepatol. 2019;17(3):469-476. doi:10.1016/j.cgh.2018.05.022

2. San Miguel Y, Demb J, Martinez ME, Gupta S, May FP. Time to colonoscopy after abnormal stool-based screening and risk for colorectal cancer incidence and mortality. Gastroenterology. 2021;160(6):1997-2005.e3. doi:10.1053/j.gastro.2021.01.219

3. Coronado GD, Rawlings AM, Petrik AF, et al. Precision patient navigation to improve rates of follow-up colonoscopy, an individual randomized effectiveness trial. Cancer Epidemiol Biomarkers Prev. 2021;30(12):2327-2333. doi:10.1158/1055-9965.EPI-20-1793

4. Barnell EK, Wurtzler EM, La Rocca J, et al. Multitarget stool RNA test for colorectal cancer screening. JAMA. 2023;330(18):1760- 1768. doi:10.1001/jama.2023.22231

5. McNamara D. Two multitarget stool tests show promise for CRC screening: studies. Medscape. Published October 22, 2023. Accessed December 20, 2023. https://www.medscape.com/viewarticle/997609#vp_1

6. Clinical validation of an optimized multi-target stool DNA (Mt-sDNA 2.0) test, for colorectal cancer screening “BLUE-C.” ClinicalTrials. gov identifier: NCT04144738. Updated September 1, 2023. Accessed December 20, 2023. https://www.clinicaltrials.gov/study/ NCT04144738

7. Universal Diagnostics. Universal DX Presents Data from Large, 1,000-patient, Multi-Cohort Study Proving 93% Sensitivity for Colorectal Cancer and 54% Sensitivity for Advanced Adenoma at 92% Specificity. Press Release. Published May 2023. Accessed January 26. 2024.

Cancer Data Trends 2024: Colorectal Cancer

References

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