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Blood-based cancer screening
- Blood-based cancer screening has been a major focus of the medical community, with particular attention paid to colorectal cancer (CRC). The laboratory advancements in data analytics have led to the development of innovative screening tests called circulating cell-free DNA (cfDNA) assays which could prove to be a less invasive method of detecting cancer. However, there is a need to assess the effectiveness, cost, and overall impact of these tests. Despite the success of traditional screening methods like faecal immunochemical testing (FIT) and sigmoidoscopy, CRC remains a major global health challenge.
- Though widely recognized, FIT fails to optimize the potential of screening programs due to its screen frequency and sensitivity limits. Current research suggests that the initial cfDNA test achieves a much higher sensitivity for CRC detection and modest sensitivity for advanced precancerous lesions. However, with a lesser focus on precancerous lesion sensitivity, potential curative opportunities could be missed.
- CRC screening has a programmatic nature which is another layer of complexity when comparing FIT-based and cfDNA-based tests. The triennial screening frequency recommended with cfDNA offsets potential benefits in favor of more effective screening approaches like FIT. Additionally, cost considerations limit the feasibility of widespread cfDNA testing; however, CF DNA blood tests have the advantage of being less invasive and potentially increasing screening uptake.
- Despite initial optimism, the highest sensitivity towards advanced precancerous lesion detection is required to fulfill the preventive potential of the cfDNA assay. The lack of specificity of blood-based tests could also lead to unnecessary procedures and anxiety thus demanding adequate education programs in the field. Concerns must therefore be weighed against the promise of early detection using these tests.
- The introduction of cfDNA-based CRC screening is a critical technology in cancer diagnostics. However, the current performance characteristics suggest it is better suited to achieve prevention among individuals who would otherwise remain unscreened. Rigorous evaluation of the effectiveness, safety, and cost-effectiveness of these tests is necessary before they can be integrated within the existing programs. Therefore, improving the cost-effectiveness of detecting early-stage CRC and precancerous lesions is paramount to the effectiveness of the screening process and moves the integrated program forward to advance the pursuit of CRC prevention.
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