A cell-free DNA colorectal cancer screening test promising enhanced accessibility and early detection.

IF 2.5 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY International Journal of Colorectal Disease Pub Date : 2024-10-15 DOI:10.1007/s00384-024-04706-8
Mahsheed Tariq, Mansoor Ahmed, Marwa Khan, Fawad Khan
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Abstract

Colorectal cancer (CRC) remains a significant global health challenge, with approximately 1.9 million new cases and 930,000 deaths reported in 2020. The highest incidence rates are observed in Australia/New Zealand and Europe, while lower rates are found in Africa and Southern Asia. Projections for 2040 indicate a rise to 3.2 million new cases and 1.6 million deaths, particularly in high development index regions, underscoring the need for improved prevention and detection. Despite advancements in screening methods and polyp removal, CRC mortality remains high in the United States due to non-adherence to recommended tests. Barriers such as cost and lack of insurance contribute to this issue. Cell-free DNA (cfDNA) blood-based testing offers a promising alternative, with studies showing 83.1% sensitivity for CRC and 89.6% specificity for advanced neoplasia, comparable to traditional screening methods but with reduced risk of adverse events. The recent FDA approval of the Shield blood test, which has demonstrated 83% efficacy in detecting late-stage CRC, represents a significant advancement. Incorporating cfDNA testing into screening protocols could improve accessibility and compliance, especially for those unwilling or unable to undergo more invasive procedures. Regular evaluation of cfDNA testing, including Shield, is essential for enhancing CRC screening strategies and patient outcomes.

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无细胞 DNA 大肠癌筛查试验有望提高可及性和早期检测率。
结肠直肠癌(CRC)仍然是全球健康面临的重大挑战,据报告,2020 年将有约 190 万新发病例和 93 万死亡病例。澳大利亚/新西兰和欧洲的发病率最高,而非洲和南亚的发病率较低。2040 年的预测显示,新发病例将增加到 320 万例,死亡人数将增加到 160 万,尤其是在高发展指数地区,这突出表明需要加强预防和检测。尽管在筛查方法和息肉切除方面取得了进步,但在美国,由于不坚持建议的检查,CRC 死亡率仍然很高。费用和缺乏保险等障碍造成了这一问题。研究显示,无细胞 DNA(cfDNA)血液检测对 CRC 的灵敏度为 83.1%,对晚期肿瘤的特异性为 89.6%,与传统筛查方法相当,但不良反应风险较低。最近,美国食品及药物管理局批准了 Shield 血液检测,该检测对晚期 CRC 的检测有效率为 83%,这是一项重大进步。将 cfDNA 检测纳入筛查方案可提高筛查的可及性和依从性,尤其是对于那些不愿意或无法接受更具侵入性手术的患者。对 cfDNA 检测(包括 Shield)进行定期评估对于改进 CRC 筛查策略和患者预后至关重要。
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来源期刊
CiteScore
4.90
自引率
3.60%
发文量
206
审稿时长
3-8 weeks
期刊介绍: The International Journal of Colorectal Disease, Clinical and Molecular Gastroenterology and Surgery aims to publish novel and state-of-the-art papers which deal with the physiology and pathophysiology of diseases involving the entire gastrointestinal tract. In addition to original research articles, the following categories will be included: reviews (usually commissioned but may also be submitted), case reports, letters to the editor, and protocols on clinical studies. The journal offers its readers an interdisciplinary forum for clinical science and molecular research related to gastrointestinal disease.
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