Multitarget Stool DNA Screening in Clinical Practice: High Positive Predictive Value for Colorectal Neoplasia Regardless of Exposure to Previous Colonoscopy.

"CONFLICTS OF INTEREST Guarantor of the article: John B. Kisiel, MD. Specific author contributions: J.D.E.: data collection, data analysis, drafting and revision of the manuscript, and is the first author. D.W.E.: data collection and data analysis. J.B.: data collection. A.K.: data collection and critical revision. E.R.: data collection. M.E.D.: data collection. K.L.L.: data collection. K.D.: data collection. S.T.: data collection. K.N.B.: data analysis and interpretation. D.W.M.: data analysis and interpretation. D.O.P.: critical revision. M.B.W.: critical revision. S.R.G.: critical revision. L.J.F.: critical revision. P.L.: critical revision. B.B.: critical revision. D.A.A.: critical revision, intellectual content, and funding. J.B.K.: concept and design, data analysis, critical revision, and is the guarantor of the article. Financial support: NIH (CA214679) to J.B.K., Schulze Family Foundation to DAA and J.B.K. Potential competing interests: The Mayo Clinic and Exact Sciences (Madison, WI) own intellectual property under which D.A.A., J.B.K., and D.W.M. are listed as inventors and may receive royalties in accordance with the Mayo Clinic policy. P.L. serves as a chief medical officer for Exact Sciences through a contracted services agreement with the Mayo Clinic. P.L. and the Mayo Clinic have contractual rights to receive royalties through this agreement. B.B. is a consultant to Exact Sciences and had no role in the funding or conduct of the study. J.D.E., D.W.E., J.B., A.K., E.R., D.O.P., M.B.W., S.R.G., & L.J.F. and M.E.D., K.D., K.L.L., S.T., and K.N.B. have no conflicts to disclose.Study HighlightsWHAT IS KNOWN✓ Colonoscopy is the gold standard for CRC screening but has important limitations.✓ MT-sDNA testing, a noninvasive screening modality for CRC, has high sensitivity and specificity for colorectal neoplasia.✓ Other CRC screening methods have variable performance in the proximal colon.WHAT IS NEW HERE✓ Nearly 1 in 4 persons screened by MT-sDNA were more than 10 years overdue to begin participation in colorectal cancer screening.✓ Adherence to diagnostic colonoscopy after positive MT-sDNA testing is high.✓ The positive predictive value of MT-sDNA for colorectal neoplasia is high even in those with previous exposure to colonoscopy.✓ Most patients with polyps detected by MT-sDNA screening have right-sided neoplasia."

"Financial support: NIH (CA214679) to J.B.K., Schulze Family Foundation to DAA and J.B.K."