| Background: Globally, colorectal cancer (CRC) is the third most common cancer and the second leading cause of
death from cancer. Incidence and mortality from CRCboth can be reduced and prevented using screening and
early detection programs. The current study aimed to assess the feasibility of the colorectal cancer screening
program in Northwest of Iran.
Methods: The study designed as a cross-cultural analytic study, to evaluate the diagnostic accuracy of stool-based
tests compared with colonoscopy, during 2016–2020. All individuals first were assessed with our CRC risk
assessment tool, then eligible volunteers entered the study. Colonoscopy was performed on all participants, also
stool-based tests including traditional guaiac, high-sensitivity guaiac-based, fecal immunochemical test (FIT),
and multitarget stool DNA (Mt-sDNA) panel tests were performed.
Results: Mt-sDNA test panel had a sensitivity of 77.8% (95% CI: 40–97.2)for detecting colorectal cancer with a
specificity of 91.2% (95% CI:85.4–95.2). The FIT test alone had a lower sensitivity (66.7%; 95% CI:29.9–92.5)
and almost the same specificity of 93.9% (95% CI: 88.7–97.2) for cancer detection. Mt-sDNA test had better
diagnostic accuracy than the FIT (AUC = 0.85 vs 0.80), and is a more useful screening test. Positive and negative
predictive values for cancer detection for both Mt-sDNA and FIT tests were almost the same results, however MtsDNA test had better NPV results than the FIT test alone.
Conclusion: Our results showed that both Mt-sDNA panel and the FIT test had acceptable cut-off points for cancer
detection, however, Mt-sDNA test had better diagnostic accuracy. |