Taha Qazi, MD: Blue-C Multi-Target Stool DNA Test, Other Noninvasive Options for CRC Screening

In the late 1990s, colorectal cancer (CRC) was the fourth-leading cause of cancer death in both men and women younger than 50 years of age. Now, the American Cancer Society cites it as the leading cause in men and second-leading cause in women, underscoring the importance of screening and the need for strategies to increase screening adherence.

Many believe noninvasive screening tools could be the answer, one of which was highlighted in the fifth installment of Qazi Corner, a collaborative quarterly newsletter on gastroenterology research, news, and trends between HCPLive and editor-in-chief Taha Qazi, MD, with an article spotlighting the BLUE-C trial of next-generation Cologuard, a multi-target stool DNA test in development for CRC and advanced precancerous lesions.

“It's well known that our current practices for colon cancer prevention and screening not only save lives but also allow us to detect cancer at an earlier rate and prevent deaths associated with colon cancer,” Qazi, a gastroenterologist with the Cleveland Clinic, explained in an interview with HCPLive, but also pointed out “Our current screening and surveillance strategies don't have the same adherence as we sort of would like them to have.”

He described BLUE-C as a “timely topic” due to March being CRC awareness month, but also pointed out its relevance in the ongoing discussion about tests for increasing adherence to screening and surveillance that may be considered more palatable by patients.

However, specificity has been an issue when it comes to non-invasive screening tests using stool DNA molecular markers. The newly developed, multi-target DNA test examined in BLUE-C aims to address concerns regarding specificity without sacrificing sensitivity and was compared to FIT, which Qazi regarded as a potential limitation of the study given there is an older version of the multi-target stool test that was not compared in the study.

Still, against FIT, he explained the next-generation test had a better sensitivity for CRC and advanced pre-cancerous lesions, but the specificity was lower for advanced neoplasia.

“It basically encompasses additional DNA markers that increases the sensitivity without any losses of specificity, which is I think the biggest goal of the study,” Qazi explained, but was careful to add he believes colonoscopy is not going anywhere, even with the advent of new non-invasive tests: “I think colonoscopy is here to stay and I think it's one of the most valuable tests we have in our armamentarium to understand colon cancer, not only to diagnose, but also to prevent its occurrence.”

Rather, he described the role of tests like the next-generation multi-target stool DNA test as a way to “expand” the current surveillance and screening platform.

Read Qazi's article from Qazi Corner Issue 5 here