{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T18:08:19Z","timestamp":1780596499017,"version":"3.54.1"},"reference-count":86,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Colorectal cancer (CRC) is responsible for a high cancer burden and a high number of deaths all over the world, although effective screening can make it preventable to a significant extent. Stool-based tests, such as the fecal immunochemical test (FIT) and multitarget stool DNA (mt-sDNA) testing, are gaining considerable popularity as non-invasive procedures that can be a replacement for colonoscopies for people at an average risk for colon cancer. Despite evidence from several randomized controlled trials supporting the use of these tests for colorectal cancer screening, their external validity in a real-world setting is influenced by many factors such as adherence, timely follow-up post testing, the healthcare cost burden, accessibility and the capacity of the health system. In this article, we have performed an extensive narrative literature review of research published between 2020 and 2025 comparing FIT and the mt-sDNA test with reference to diagnostic accuracy, cost-effectiveness, adherence and outcomes of implementation. We discuss the issues of sensitivity and specificity, look at post-test requirements for colonoscopy and check if there is any discrimination in healthcare. These findings suggest that FIT and mt-sDNA tests should not be considered competing technologies but rather complementary screening methods, with their overall effectiveness contingent upon appropriate patient selection and widespread system-level implementation. It is crucial to combine strategic test selection with a robust follow-up infrastructure to ensure that the entire population benefits from the CRC prevention program.<\/jats:p>","DOI":"10.3390\/jcm15114219","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T17:36:18Z","timestamp":1780076178000},"page":"4219","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Fecal Immunochemical Test and Multitarget Stool DNA Testing for Colorectal Cancer Screening in Real-World Practice: A Literature Review"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-2698-0128","authenticated-orcid":false,"given":"Ashish","family":"Sharma","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Yale New Haven Hospital, New Haven, CT 06510, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-9018-8328","authenticated-orcid":false,"given":"Angad","family":"Tiwari","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Maharani Laxmi Bai Medical College, Jhansi 284128, Uttar Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8250-535X","authenticated-orcid":false,"given":"Ishita","family":"Ray","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Mahatma Gandhi Memorial Medical College, Indore 452001, Madhya Pradesh, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8027-106X","authenticated-orcid":false,"given":"Ruchir","family":"Paladiya","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Connecticut School of Medicine, Hartford, CT 06106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6801-0633","authenticated-orcid":false,"given":"Harendra","family":"Kumar","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0519-4121","authenticated-orcid":false,"given":"Sukhmani","family":"Sidhu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Connecticut School of Medicine, Hartford, CT 06106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saloni","family":"Haldule","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Connecticut School of Medicine, Hartford, CT 06106, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7979-2834","authenticated-orcid":false,"given":"Hareesha Rishab","family":"Bharadwaj","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Royal Stoke University Hospital, University Hospitals of North Midlands NHS, Stoke-on-Trent ST4 6QG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saqr","family":"Alsakarneh","sequence":"additional","affiliation":[{"name":"Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manesh Kumar","family":"Gangwani","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University of Arkansas For Medical Sciences, Little Rock, AR 72205, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassam","family":"Ali","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Hepatology and Nutrition, Brody School of Medicine, East Carolina University, Greenville, NC 27834, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8544-9039","authenticated-orcid":false,"given":"Dushyant Singh","family":"Dahiya","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology & Motility, The University of Kansas School of Medicine, Kansas City, KS 66160, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"ref_1","first-page":"209","article-title":"Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA A Cancer J. 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