CC BY-NC-ND 4.0 · Endosc Int Open 2024; 12(04): E474-E487
DOI: 10.1055/a-2256-3411
Review

Sessile serrated polyp detection rates after fecal immunochemical test or multitarget stool DNA test: Systematic review and meta-analysis

Rajat Garg
1   Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, United States (Ringgold ID: RIN2569)
,
Carol A. Burke
2   Internal Medicine, Cleveland Clinic Foundation, Cleveland, United States (Ringgold ID: RIN2569)
,
Manik Aggarwal
1   Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, United States (Ringgold ID: RIN2569)
,
Carole Macaron
1   Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, United States (Ringgold ID: RIN2569)
,
2   Internal Medicine, Cleveland Clinic Foundation, Cleveland, United States (Ringgold ID: RIN2569)
,
Michelle K. Kim
2   Internal Medicine, Cleveland Clinic Foundation, Cleveland, United States (Ringgold ID: RIN2569)
,
Miguel Regueiro
2   Internal Medicine, Cleveland Clinic Foundation, Cleveland, United States (Ringgold ID: RIN2569)
,
Bhatt Amit
1   Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, United States (Ringgold ID: RIN2569)
,
Prabhleen Chahal
2   Internal Medicine, Cleveland Clinic Foundation, Cleveland, United States (Ringgold ID: RIN2569)
,
3   Medicine, University of Arkansas System, Little Rock, United States (Ringgold ID: RIN3342)
› Author Affiliations

Abstract

Background and study aims Published studies report a higher adenoma detection rate (ADR) for FIT-DNA as compared with FIT. Data are less replete about the performance of stool-based tests for sessile serrated polyp (SSP) detection. We performed a meta-analysis to evaluate the performance of FIT and FIT-DNA testing for SSP detection rate (SSPDR) in patients undergoing colonoscopy for follow up of positive noninvasive tests.

Methods A comprehensive literature search of multiple databases (until September 2022) was performed to identify studies reporting SSPDR in patients with positive FIT or FIT-DNA tests. The outcome was overall colonoscopy detection of any SSPs and advanced serrated polyps (ASP: SSP ≥ 10 mm and/or dysplasia).

Results Included were 482,405 patients (52.4% females) with a mean age of 62.3 ± 4.4 years from 23 studies. The pooled SSPDR for all positive stool-based tests was 5.3% and higher for FIT-DNA (15.0%, 95% confidence interval [CI] 8.3–25.7) versus FIT (4.1%, 95% CI 3.0–5.6; P = 0.0002). The overall pooled ASP detection rate was 1.4% (95% CI 0.81–2.3) and higher for FIT-DNA (3.8 %, 95% CI 1.7–8.6) compared with FIT (0.71%, 95% CI 0.36–1.4; P<0.01). SSPDR with FIT-DNA was also significantly higher than FIT when the FIT cutoff was >10 ug/g and in FIT-positive patients in studies conducted in North America (P<0.05).

Conclusions FIT-DNA outperformed FIT in both SSP and ASP detection including FIT with a lower threshold cutoff of >10 ug/g. Further comparative studies are needed to assess the impact of our findings on colorectal cancer reduction.

Supplementary Material



Publication History

Received: 10 August 2023

Accepted after revision: 23 January 2024

Accepted Manuscript online:
29 January 2024

Article published online:
05 April 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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Rüdigerstraße 14, 70469 Stuttgart, Germany

 
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