Multitarget Stool DNA Tests More Costly Than FIT for Colorectal Cancer Detection
WEDNESDAY, May 14, 2025 -- Multitarget stool DNA test (MSDT)- and next-generation MSDT (N-G MSDT)-based screening have higher costs per detected advanced neoplasia case or early colorectal cancer (CRC) case than fecal immunochemical tests (FITs), according to a research letter published online May 13 in the Annals of Internal Medicine.
Noting that MSDTs have higher sensitivity than FITs and are increasingly used for CRC screening, Hermann Brenner, M.D., M.P.H., from the German Cancer Research Center in Heidelberg, and colleagues compared screening costs per relevant target finding of CRC screening for FITs, MSDTs, and N-G MSDTs based on the results of two studies.
The researchers found that per detected advanced neoplasia case or per early detected CRC case, the screening costs were approximately sevenfold to ninefold higher for MSDT- and N-G MSDT-based screening than for FIT-based screening, assuming 60 percent uptake of colonoscopy after a positive fecal test result. Per additional early-detected CRC case, costs were more than $700,000 for both MSDT- and N-G MSDT-based screening compared with FIT-based screening, and these costs were about 40 and 30 times higher, respectively, than costs for the FIT-detected CRC cases. The cost per additional case of CRC or advanced neoplasia detected by MSDT or N-G MSDT compared with FIT would still be manyfold higher even if the costs per test for MSDT and N-G MSDT were lowered to $100 (i.e., less than 20 percent of the current costs).
"Our results indicate that there would be much to gain if the current trends of decreasing FIT use rates and increasing MSDT use rates in the United States could be reversed," the authors write.
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