A Review of Colorectal Cancer Detection Modalities, Stool DNA, and Fecal Immunochemistry Testing in Adults Over the Age of 50

Colorectal cancer (CRC) is the third leading cause of cancer death in the United States. Recently, more focus has been placed on developing effective screening tools to detect the presence of both precancerous and cancerous lesions present in the colon and rectum. Colonoscopy has been well established as the gold standard of the colon and rectal cancer screening. However, not all patients are willing to undergo a colonoscopy due to the procedure's invasive nature. Non-invasive screening methods have been developed to appeal to patients who refuse colonoscopy. Fecal occult blood tests have long been used by physicians, in addition to colonoscopy, in an effort to screen for CRC. New screening methods, such as fecal immunochemical test (FIT) and stool DNA (sDNA) testing, have been developed as a more sensitive screening measure to attempt to accurately screen patients who have precancerous or cancerous colorectal lesions. This article compares CRC screening techniques through literature review in order to determine which tests offer the most sensitive detection of CRC and precancerous lesions in average-risk adults over the age of 50 years old. Through this review, it can be seen that sDNA is more sensitive than FIT in detecting all stages of CRC, as well as precancerous lesions.