The Resource Fecal DNA testing in screening for colorectal cancer in average-risk adults, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Oregon Evidence-based Practice Center ; investigators, Jennifer S. Lin [and others], (electronic resource)

Fecal DNA testing in screening for colorectal cancer in average-risk adults, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Oregon Evidence-based Practice Center ; investigators, Jennifer S. Lin [and others], (electronic resource)

Label
Fecal DNA testing in screening for colorectal cancer in average-risk adults
Title
Fecal DNA testing in screening for colorectal cancer in average-risk adults
Statement of responsibility
prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Oregon Evidence-based Practice Center ; investigators, Jennifer S. Lin [and others]
Contributor
Subject
Genre
Language
eng
Summary
OBJECTIVES: To review the evidence on fecal DNA testing to screen for colorectal cancer in adults at average risk for colorectal cancer. DATA SOURCES: We searched MEDLINE, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, Database of Abstracts of Reviews of Effects, and the Health Technology Assessments Database from 2000 through August 11, 2011 and grey literature including recent conference abstracts, regulatory documents, unpublished information from the manufacturer, and expert suggestions. REVIEW METHODS: Two investigators independently reviewed all abstracts and full-text articles against a set of a priori inclusion criteria and assessed the quality of included articles using established criteria. Disagreements were resolved through consultation of a third investigator. We evaluated and summarized clinical and methodological characteristics and internal and external validity of studies. Finally, we assessed the overall strength of evidence for each outcome based on risk of bias, consistency, directness, and precision of the evidence. RESULTS: Despite the availability of numerous excluded initial validation studies of fecal DNA testing, we found only three studies that examined the test accuracy of fecal DNA testing in screening populations. Initial validation studies were excluded due to their use of highly selected patient populations. Two fair-quality diagnostic accuracy studies (n=5004) evaluating a multi-marker fecal DNA found differing sensitivities to detect CRC (25 percent [95% CI, 5 to 57 percent] versus 51.6 percent, [95% CI, 34.8 to 68.0]). Sensitivity for advanced adenomas was similarly low in both studies. Another small study and a subset analysis of one of the larger studies were both poor quality and evaluated different tests. We found no studies that specifically evaluated the harms of fecal DNA testing. While three poor-quality analytic validity studies showed that technological advances can improve the analytic sensitivity of assays, it is unclear if these advances are applicable to the currently available test. Six fair-to poor-quality studies that evaluated acceptability found that fecal DNA testing is generally acceptable, although an important test attribute for acceptability appears to be the test's accuracy (which is yet unknown). No studies have evaluated the relative acceptability of fecal DNA tests to FIT tests. CONCLUSIONS: Fecal DNA tests have insufficient evidence about its diagnostic accuracy to screen for colorectal cancer in asymptomatic, average-risk patients. There is also insufficient evidence for the harms, analytic validity, and acceptability of testing in comparison to other screening modalities. Existing evidence has little or no applicability to currently available fecal DNA testing
Member of
Cataloging source
NLM
Funding information
Prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Oregon Evidence-based Practice Center
Government publication
federal national government publication
Illustrations
illustrations
Index
no index present
Literary form
non fiction
Nature of contents
  • dictionaries
  • bibliography
NLM call number
WI 529
http://library.link/vocab/relatedWorkOrContributorDate
1974-
http://library.link/vocab/relatedWorkOrContributorName
  • Lin, Jennifer
  • United States
  • Oregon Health & Science University
  • Effective Health Care Program (U.S.)
  • Effective Health Care Program (U.S.)
Series statement
  • Comparative effectiveness review
  • AHRQ publication
Series volume
  • no. 52
  • no. 12-EHC022-EF
http://library.link/vocab/subjectName
  • Colorectal Neoplasms
  • Colorectal Neoplasms
  • Feces
  • Mass Screening
  • Occult Blood
  • Sensitivity and Specificity
  • United States
  • United States
http://bibfra.me/vocab/relation/supportingbody
RzTDSdffmEM
Label
Fecal DNA testing in screening for colorectal cancer in average-risk adults, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Oregon Evidence-based Practice Center ; investigators, Jennifer S. Lin [and others], (electronic resource)
Instantiates
Publication
Note
"February 2012."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier
Content category
text
Content type code
txt
Content type MARC source
rdacontent
Control code
789838382
Extent
1 online resource (85 pages)
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
c
Other physical details
illustrations
Specific material designation
remote
System control number
(OCoLC)789838382
Label
Fecal DNA testing in screening for colorectal cancer in average-risk adults, prepared for Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services ; prepared by Oregon Evidence-based Practice Center ; investigators, Jennifer S. Lin [and others], (electronic resource)
Publication
Note
"February 2012."
Bibliography note
Includes bibliographical references
Carrier category
online resource
Carrier category code
cr
Carrier MARC source
rdacarrier
Content category
text
Content type code
txt
Content type MARC source
rdacontent
Control code
789838382
Extent
1 online resource (85 pages)
Form of item
online
Media category
computer
Media MARC source
rdamedia
Media type code
c
Other physical details
illustrations
Specific material designation
remote
System control number
(OCoLC)789838382

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