is a major public health issue, with over 43,000 new cases and nearly 17,700 deaths annually in France. The overall survival rate is currently 63%. It is much higher for early stages than for advanced stages. Screening allows for the diagnosis of the disease in its early stages, when it is responsive to curative treatment, thus reducing specific CRC mortality.
The yield of the test remains low in France, however. It is around 36%, which is below the 45% minimum adherence recommended by the European agency, suggesting a need for other approaches. Hence, the attention given to a new type of blood test that uses cell-free DNA or circulating free DNA from circulating blood. Different from tests that use circulating tumor DNA, the new test could improve screening compliance, detect CRC earlier, and reduce mortality.
This study used circulating cfDNA from total blood to detect alterations, aberrant methylation, and DNA fragment modifications in nearly 7900 participants. The blood test, the composition of which is not fully known, appears to be more effective than its competitor, Septin-9, thus avoiding the need for stool collection.
This new fecal test also retained a sensitivity of 43.4% for detecting advanced polyps. The specificity of 90.6% should increase detection efficiency for users by reducing false-positive results and subsequent colonoscopies.The optimal screening test must meet the following criteria: Satisfactory specificity and sensitivity rates, good patient adherence, low cost, good reproducibility, and low complication risk.