A recent study highlights the superior performance of the multitarget stool RNA test (mt-sRNA) in colorectal cancer (CRC) screening, surpassing other molecular tests in detecting advanced adenomas and preventing CRC-related deaths. This research provides critical insights into optimizing screening strategies for individuals aged 45 and older.
Molecular Tests vs. Traditional Screening
The study utilized a 10-year Markov model to simulate disease progression, comparing mt-sRNA (ColoSenseA) with other molecular tests like CologuardA, Cologuard PlusA, Shield’s cfDNA, and the fecal immunochemical test (FIT). Findings revealed that mt-sRNA not only identified the most advanced adenomas but also referred the highest number of individuals for surveillance. At a real-world adherence rate of 60%, mt-sRNA reduced CRC cases by 1% and deaths by 14% compared to FIT, demonstrating significant clinical benefits over other testing methods.
Cost-Effectiveness Analysis
Economic evaluations showed that FIT remained the most cost-effective strategy across all adherence levels, priced at $25 per test. However, for molecular tests conducted every three years, mt-sRNA emerged as the most cost-effective option at $508 per test. When comparing costs to prevent CRC cases and deaths, mt-sRNA proved more economical than mt-sDNA, mt-sDNA+, and cfDNA, highlighting its value in healthcare budgeting and resource allocation.
- mt-sRNA demonstrated higher sensitivity in detecting advanced adenomas compared to other molecular tests.
- At 60% adherence, mt-sRNA significantly reduced CRC-related mortality over alternative screening methods.
- FIT remains the most cost-effective screening tool, making it a viable option for broad implementation.
- Cost per prevented CRC case and death is substantially lower with mt-sRNA compared to cfDNA.
Integrating mt-sRNA into CRC screening programs could enhance early detection and reduce mortality rates, especially in settings where molecular testing is feasible. However, balancing clinical benefits with cost-effectiveness is crucial for widespread adoption. Healthcare providers may consider mt-sRNA as a complementary tool to existing screening methods, particularly for high-risk populations.
The study underscores the importance of selecting appropriate screening strategies based on both clinical efficacy and economic viability. By prioritizing tests like mt-sRNA that offer substantial health benefits, medical professionals can improve patient outcomes while maintaining cost efficiency. Ongoing research and real-world data will further inform optimal CRC screening practices, ensuring that advancements in molecular testing translate into tangible public health gains.
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