title: DNA from fecal immunochemical test can replace stool for detection of colonic lesions using a microbiota-based model.
abstract: There 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 patient's stool sample.
  
  
  
  Using 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. We 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.
  
  
  
  These 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.
authors.affiliation: Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA.|Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Nielson T
authors.initials: NT
authors.lastname: Baxter
authors.affiliation: Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Charles C
authors.initials: CC
authors.lastname: Koumpouras
authors.affiliation: Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
authors.forename: Mary A M
authors.initials: MA
authors.lastname: Rogers
authors.affiliation: Department of Family and Community Medicine, Penn State Hershey Medical Center, Hershey, PA, USA.
authors.forename: Mack T
authors.initials: MT
authors.lastname: Ruffin
authors.affiliation: Department of Microbiology and Immunology, University of Michigan, Ann Arbor, MI, USA. pschloss@umich.edu.
authors.forename: Patrick D
authors.initials: PD
authors.lastname: Schloss
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001419:Bacteria / Q000145:classification / Q000302:isolation & purification*; D001483:Base Sequence; D015179:Colorectal Neoplasms / Q000097:blood / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods*; D006403:Hematologic Tests / Q000379:methods*; D006801:Humans; D007120:Immunochemistry / Q000379:methods; D008403:Mass Screening / Q000379:methods*; D064307:Microbiota; D008875:Middle Aged; D009780:Occult Blood; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D017422:Sequence Analysis, DNA
chemical_list: D012336:RNA, Ribosomal, 16S
keywords: Colorectal cancer; Fecal immunochemical test; Gut microbiome; Microbiota; Random forest