“Blood Test for Cancer”: Accuracy Up to 83% for Colorectal Cancer
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“Blood Test for Cancer”: Accuracy Up to 83% for Colorectal Cancer
Accuracy Up to 83%: “Blood Test for Cancer” May Be a New Screening Strategy for Colorectal Cancer.
A recent study published in the New England Journal of Medicine (NEJM) suggests that using plasma circulating free DNA (cfDNA) testing for screening colorectal cancer can achieve a sensitivity of up to 83% and a specificity of 90% for advanced tumors, with a sensitivity of 13% for advanced tumor precancerous lesions.
screenshot source: NEJM
The study evaluated the use of cfDNA in screening asymptomatic and early-stage colorectal cancer in a population meeting colorectal cancer screening criteria. Researchers recruited 22,877 participants aged 45 to 84 from 265 U.S. research centers from October 2019 to September 2022, including 65 participants diagnosed with colorectal cancer by colonoscopy (48 with stage I, II, or III colorectal cancer), with a final 7,861 participants meeting the requirements.
Among the 65 participants with colonoscopically diagnosed colorectal cancer, 54 had positive cfDNA test results and 11 had negative results, resulting in an overall sensitivity of cfDNA blood testing of 83.1% (95% CI = 72.2-90.3), with the lower limit of the 95% CI exceeding the 65% qualifying standard established for other colorectal cancer screenings approved by the U.S. FDA.
cfDNA testing identified 42 of 48 different staged colorectal cancers (sensitivity 87.5%, 95% CI = 75.3-94.1), including:
– 11 of 17 stage I colorectal cancers (sensitivity 65%, 95% CI = 41-83);
– 14 of 14 stage II colorectal cancers (sensitivity 100%, 95% CI = 78-100);
– 17 of 17 stage III colorectal cancers (sensitivity 100%, 95% CI = 82-100);
Among 1,116 participants diagnosed with late-stage lesions by colonoscopy, 147 (13.2%) tested positive by cfDNA, indicating a sensitivity for late-stage precancerous lesions of 13.2% (95% CI = 11.3-15.3). Even with different histopathological characteristics, tumor sizes, or locations of late-stage precancerous lesions, there was no significant difference in sensitivity determined by cfDNA testing.
In participants without any colorectal tumors (colorectal cancer or late-stage precancerous lesions) found by colonoscopy, 89.6% tested negative by cfDNA, and 10.4% tested positive, indicating a specificity for late-stage tumors of 89.6% (95% CI = 88.8-90.3), with the lower limit of the 95% CI exceeding the predefined qualifying standard of 85%.
Among participants with negative colonoscopy results, 89.9% tested negative by cfDNA, and 10.1% tested positive, indicating a false positive rate of 10.1% and a tumor specificity of 89.9% (95% CI = 89.0-90.7).
“This study represents a hopeful step toward developing more convenient tools for detecting early colorectal cancer,” said William M, the lead author of the study from the Fred Hutchinson Cancer Research Center. “cfDNA testing for colorectal cancer has a similar accuracy to early cancer fecal testing, providing an alternative for patients who cannot or refuse to accept current screening methods.”
In conclusion, the study’s results show that cfDNA blood testing for colorectal cancer has a sensitivity of 83%, a specificity of 90% for late-stage tumors, and a sensitivity of 13% for late-stage tumor precancerous lesions. Given the increasing incidence of colorectal cancer in individuals under 45, understanding strategies based on blood testing to expand the age range for colorectal cancer screening is of potential clinical significance.
“Blood Test for Cancer”: Accuracy Up to 83% for Colorectal Cancer
References:
[1] Chung DC, Gray DM, Singh H, et al. A Cell-free DNA Blood-Based Test for Colorectal Cancer Screening. N Engl J Med. 2024 Mar 14;390(11):973-983. doi: 10.1056/NEJMoa2304714. PMID: 38477985.
[2] RED HUTCHINSON CANCER CENTER. Clinical study of a blood test shows 83% accuracy for detecting colorectal cancer. https://www.eurekalert.org/news-releases/1037242
(source:internet, reference only)
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