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Liquid Biopsy for Colorectal Cancer Screening: A Potential but Not Yet Cost-Effective Alternative to Colonoscopy

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Medriva Correspondents
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Liquid Biopsy for Colorectal Cancer Screening: A Potential but Not Yet Cost-Effective Alternative to Colonoscopy

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Emerging Blood-Based Liquid Biopsy Tests for Colorectal Cancer

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Developments in the field of colorectal cancer (CRC) screening are offering new hope to patients uncomfortable with traditional colonoscopy. Blood-based liquid biopsy tests, an emergent technology in the field, could provide a less invasive alternative. However, while these tests are promising, an economic analysis by researchers at Columbia University Irving Medical Center in New York suggests that they may not be a cost-effective screening tool at this stage.

Cost-Effectiveness of CRC Screening Methods

The study compared the cost effectiveness of various CRC screening strategies. The results showed that colonoscopy remains the most cost-effective strategy, with an incremental cost-effectiveness ratio of $28,071 per life-year gained. In comparison, liquid biopsy greatly exceeded the accepted threshold of cost-effectiveness. For liquid biopsy to become a viable option, its cost would have to be reduced significantly, by an estimated 66% to be exact, to increase uptake among the general population.

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Accuracy of Blood-Based Biomarkers in CRC Detection

Another crucial aspect of CRC screening is the detection of advanced pre-cancerous lesions. A systematic review evaluated the accuracy of blood-based biomarkers for this purpose. The review identified 133 unique biomarker sets, with the best performing test being a panel of 6 miRNAs that demonstrated a sensitivity of 95% and specificity of 90% for advanced pre-cancerous lesions. These figures underline the potential of blood-based biomarkers, but also highlight the importance of further refining these tests to improve their accuracy and cost-effectiveness.

Improving Treatment Stratification with Technology

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Moreover, the integration of technology in the CRC screening process can enhance the treatment stratification of patients post-surgery. Artificial intelligence-generated digital pathology tools, in combination with conventional histopathological assessment and circulating tumor DNA (ctDNA) analysis, are offering a novel paradigm for personalized adjuvant treatment of colorectal cancer. This innovative approach demonstrates the potential benefits of personalizing treatment strategies for CRC patients.

Concluding Thoughts

While the emergence of liquid biopsy for CRC screening opens up exciting possibilities for non-invasive testing, current evidence suggests that it is not yet a cost-effective alternative to colonoscopy. However, ongoing research and technological advancements in the field may soon change this scenario. As we look to the future, the integration of artificial intelligence and the refinement of blood-based biomarkers promise to revolutionize CRC screening and treatment strategies.

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