Stool DNA Testing for Colorectal Cancer: Development and Advances

ABSTRACT

Screening for colorectal cancer is one of the most effective public health interventions. Although colonoscopy is the preferred method in many settings, colonoscopy can miss lesions, interval neoplasms can arise after a normal colonoscopy, and some patients refuse to undergo colonoscopy. In the last decade, detection of neoplasia-associated genetic alterations in the stool has become feasible. First-generation stool DNA tests demonstrated better sensitivity for colorectal cancer than fecal occult blood tests. Improvements to stool DNA tests have made them more sensitive and less complex. The newer marker panels can detect colorectal cancer and even the majority of advanced adenomas, regardless of location in the colon. This review summarizes the development and advances to stool DNA testing for colorectal cancer.