Stool-Based Colorectal Cancer Screening in Practice

In this episode, ‘Stool-Based Colorectal Cancer Screening in Practice,’ the expert faculty explore stool-based colorectal cancer (CRC) screening options, focusing on practical considerations, test performance, and real-world implementation challenges in primary care. The discussion highlights key differences among fecal occult blood test (gFOBT), fecal immunochemical test (FIT), and multitarget stool DNA tests, emphasizing how advancements in technology have improved sensitivity and expanded screening options.

Traditional gFOBT requires dietary restrictions and annual testing, which can create barriers for patients and increase the risk of false-positive results. FIT offers improved sensitivity and fewer dietary limitations, making it a more patient-friendly option. Multitarget stool DNA testing further enhances detection by identifying biomarkers associated with CRC, achieving sensitivities approaching those of colonoscopy while requiring less frequent testing as compared to the other two stool-based tests.

Beyond test performance, the panelists discuss the importance of proper patient preparation and communication, particularly for colonoscopy. Adequate bowel preparation is critical for accurate results, and medication management, including temporary discontinuation of GLP-1 receptor agonists and anticoagulants must be carefully coordinated to avoid delays or cancellations. These logistical considerations can impact screening completion and patient experience. The discussion reinforces that while colonoscopy remains the gold standard, stool-based tests play an increasingly important role in expanding access to CRC screening.

The next episode in this series, ‘Improving CRC Screening Adherence in Primary Care,’ features the panelists exploring how to improve CRC screening adherence requires a combination of patient education, streamlined workflows, and flexible testing options. A patient-centered approach helps ensure that more individuals completed screening and receive timely care.