DNA from fecal immunochemical test can replace stool for microbiota-based colorectal cancer screening

BackgroundThere is a significant demand for colorectal cancer (CRC) screening methods that are noninvasive, inexpensive, and capable of accurately detecting early stage tumors. It has been shown that models based on the gut microbiota can complement the fecal occult blood test and fecal immunochemical test (FIT). However, a barrier to microbiota-based screening is the need to collect and store a patients stool sample.\n\nMethodsUsing stool samples collected from 404 patients we tested whether the residual buffer containing resuspended feces in FIT cartridges could be used in place of intact stool samples.\n\nResultsWe found that the bacterial DNA isolated from FIT cartridges largely recapitulated the community structure and membership of patients stool microbiota and that the abundance of bacteria associated with CRC were conserved. We also found that models for detecting CRC that were generated using bacterial abundances from FIT cartridges were equally predictive as models generated using bacterial abundances from stool.\n\nConclusionsThese findings demonstrate the potential for using residual buffer from FIT cartridges in place of stool for microbiota-based screening for CRC. This may reduce the need to collect and process separate stool samples and may facilitate combining FIT and microbiota-based biomarkers into a single test. Additionally, FIT cartridges could constitute a novel data source for studying the role of the microbiome in cancer and other diseases.