Fecal MicroRNA-Based Algorithm Increases Effectiveness of Fecal Immunochemical Test–Based Screening for Colorectal Cancer

• DOI: 10.1016/j.cgh.2020.02.043
• Publication Date: 2020-02-28T02:40:08Z
• Authors: Saray Duran-Sanchon; Lorena Moreno; Javier Gómez-Matas; Josep M. Augé; Miquel Serra-Burriel; Míriam Cuatrecasas; Leticia Moreira; Anna Serradesanferm; Àngels Pozo; Jaume Grau; Maria Pellisé; Meritxell Gironella; Antoni Castells
• Keywords: Colorectal cancer screening; Quartile

<h3>Background & Aims</h3> An algorithm based on fecal levels of 2 microRNAs (miR-421 and miR-27a-3p), hemoglobin concentration, patient age sex can identify patients with advanced colorectal neoplasia. We investigated whether this algorithm, called miRFec, could increase effectiveness efficiency immunochemical test (FIT)-based cancer (CRC) screening programs. <h3>Methods</h3> obtained data samples from 767 persons a positive result the FIT who then underwent colonoscopy examination while participating population-based CRC program, March 2011 through May 2017 in Barcelona, Spain. Fecal miRNAs were isolated buffer contained original collection device analyzed by quantitative reverse transcription PCR. Aims to evaluate usefulness miRFec identifying at greatest risk for should be prioritized individuals low whom avoided. <h3>Results</h3> Of study subjects, 414 (54.0%) found have neoplasia (67 347 adenomas) 353 (46.0%) either non-advanced adenomas (n = 136) or normal 217). MiRFec scores (1–4) independently associated presence (P < .001). The differentiated those an area under receiver operating characteristic curve 90% (95% CI, 86–94). Subjects 4th quartile (above 3.09, high-risk group) 8-fold more likely than subjects 1st (below 2.14, low-risk group). group had predictive value below 30% detection When we used 50% specificity cut-off value, identified 97% would allow 264 (34.4%) avoid examination. <h3>Conclusions</h3> hemoglobin, (miRFec) avoided 34% colonoscopies. Inclusion FIT-based programs their efficiency.