Fecal DNA testing could reduce global colonoscopy burden: experts

“Stool-based testing offers a promising solution to reduce the burden of a colonoscopy,” experts emphasized on September 21, during the ICG 19 · Metagenomics for Health (ICG19·MH) & The 2nd MOHA Consortium. The conference was held in Harbin, Heilongjiang Province of China.

The discussions centered on colorectal cancer (CRC) screening, with experts sharing perspectives on the CRC burden and real-world case studies from their country and active research on exploring solutions to address the global CRC problem. One of the key points highlighted was the global challenge of limited access to colonoscopy, the gold standard for CRC screening.

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Dr. Yang Yun, Deputy General Manager at BGI Genomics, emphasized that “colonoscopy screening can significantly lower the incidence and mortality rates of CRC.” However, she also pointed out the widespread issue of preparation for the surgery, which limits its effectiveness as a first-line screening method. “One of the most important requirements for colonoscopy is the pass rate of intestinal preparation. The minimum requirement is 85%, but most of them fail to meet this requirement, whether in my country or other countries around the world.”

Screening obstacles

The world faces the same obstacle to CRC screening: lack of colonoscopy medical resources.

Dr. Songphol Malakorn from Chulalongkorn University, Thailand, spoke about the shortage of medical resources and the complex preoperative preparations that hinder the widespread adoption of colonoscopy in Thailand. “28 million people versus 800 plus endoscopists,” said Dr. Malakorn, “This is the main problem of the screening program of our country.”

From New Zealand, Dr. Amanda Dixon-McIver, Laboratory Director at IGENZ highlighted long waiting times for public-funded colonoscopies and the high costs of private procedures, are major deterrents for patients seeking timely diagnostic service. “Colonoscopy capacity is finite and waiting times often exceed targets,” she stated.

Similarly, in Europe, Professor Robert Benamouzig of Avicenne Hospital, France addressed how screening strategies are shaped by cultural and political contexts through the livestream. He noted that France’s healthcare system is based on collective responsibility, aiming to provide equal access to resources. Yet, even within this system, barriers to widespread CRC screening persist, highlighting the need for accessible alternatives.

Promising solution

As part of the discussions on overcoming these global challenges, experts advocated for the development of more accessible, accurate, and widely acceptable screening tools. COLOTECT®, a stool DNA testing kit developed by BGI Genomics, emerged as a promising solution.

Professor Wu Xiaojian from the Sixth Affiliated Hospital of Sun Yat-sen University shared successful screening programs were conducted in Xinyi and Huazhou, cities in Guangdong Province, using COLOTECT®. “In these 10% of positive patients, 77% went on to complete colonoscopies,” Professor Wu said. This high compliance rate, he noted, demonstrates the growing acceptance of stool DNA testing over traditional methods like the FIT test.

Both Dr. Dixon-McIver and Dr. Malakorn supported the adoption of innovative screening tools like COLOTECT®, highlighting their potential to address resource limitations and improve CRC prevention efforts, especially in underserved regions.

Gut microbiome

In addition to CRC, experts delved into the potential of gut microbiome signatures as a tool for disease detection. Professor Benamouzig shared his insights on how the gut microbiome could be instrumental in early CRC detection, while Professor Stanislav Dusko Ehrlich from University College London explored its potential in diagnosing Parkinson’s disease. Furthermore, Dr. Hamsa T. Tayeb from Saudi Arabia discussed the application of metagenomics in diagnosing infectious diseases, underscoring the potential of these innovative tools in clinical practice.

As these discussions from ICG19·MH, innovations in CRC screening, such as COLOTECT®, along with new applications of metagenomics, hold the potential to transform global health by making preventive healthcare more accessible and effective. These new tools and approaches offer a significant opportunity to reduce the global burden of diseases such as CRC.