Observational studyDigestive diseases and sciences2026
Factors Associated with Advanced Adenoma Detection by Colonoscopy After Negative Multitarget Stool DNA Testing.
Observational study in Digestive diseases and sciences, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The trial behind it
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Who cites it
3 citing papers in PubMed.
- Defining the Role of Colonoscopy After a Negative Multitarget Stool DNA.Digestive diseases and sciences · 2026Article
- Article
- Critical Appraisal of Cystic Duct Stenting Versus Other Treatment Modalities for the Management of Acute Cholecystitis in Patients with Decompensated Cirrhosis.Digestive diseases and sciences · 2026Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsMultitarget stool DNA (mt-sDNA) testing is a non-invasive colorectal cancer (CRC) screening tool, but false-negative results may delay diagnosis. Understanding which patients are more likely to have advanced lesions after a negative test is essential, particularly given real-world off-label use.
methodsWe retrospectively studied patients across a multi-site health system who had negative mt-sDNA results and underwent colonoscopy within 3 years. Negative predictive values (NPVs) for advanced adenoma (AA) and CRC were calculated. Demographics, colonoscopy indications, polyp characteristics, endoscopist training level, prior colonoscopy history, and off-label mt-sDNA use were abstracted. All assays used the original Deep-C version of Cologuard. Because only patients who underwent colonoscopy were included, NPVs represent conditional performance in this subset.
resultsAmong 370 patients, 31 (8.4%) had AA and 3 (0.8%) had CRC; 34 (9.2%) had advanced precancerous lesions (APL). AA was associated with a higher number of polyps and larger polyp size. Proximal lesions-particularly in the hepatic flexure and transverse colon-were more common among AAs. Gastrointestinal bleeding was more frequent in patients with AA (32.3% vs 14.2%). GI attendings performed 95.4% of colonoscopies and detected all AAs and CRCs. Off-label mt-sDNA testing occurred in 10.3% of patients, none of whom had AA or CRC. Prior colonoscopy was documented in 8.9% of patients.
conclusionsConditional NPVs for AA and CRC after negative mt-sDNA were 91.6% and 99.2%. Proximal lesions were more likely to be missed, highlighting the need for meticulous examination. Negative mt-sDNA results should be interpreted cautiously, particularly in symptomatic patients, and colonoscopy should be pursued when clinically indicated.
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Registered trials
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