In:
LaboratoriumsMedizin, Walter de Gruyter GmbH, Vol. 32, No. 3 ( 2008-05-01), p. 158-167
Abstract:
Fecal occult blood testing (FOBT) is the most widely prescribed screening test for colorectal cancer (CRC) because of its simplicity, non-invasiveness, and demonstrated mortality benefits. However, guaiac-based fecal blood tests (G-FOBT) suffer from poor sensitivity, a limited ability to detect early lesions, and low population compliance. These limitations have prompted many innovations in stool testing. Preliminary data on fecal proteins including calprotectin and tumor-M2-PK show better performance characteristics compared to G-FOBT. Nevertheless, these tests also suffer from low sensitivity in detecting early lesions and poor specificity, leading to high costs for follow-up of false-positive tests. Recently developed immunological tests (I-FOBT) demonstrate significantly higher sensitivity and specificity. I-FOBTs use antibodies specific for human hemoglobin and are therefore, unlike G-FOBT, not affected by diet or drug administration, leading to improved patient partipication in screening for CRC. At present, I-FOBTs seem to be the most cost-effective approach to non-invasive CRC screening. Fecal DNA analysis opens up a new field for early detection of colorectal neoplasia. Small trials of multitarget assays demonstrate a CRC sensitivity of 62–91% and adenoma sensitivity of 26–73%. The specificity of these assays is high, ranging from 93% to 100%. At present, the major drawback of fecal DNA testing compared to other fecal CRC screening tests is its high cost.
Type of Medium:
Online Resource
ISSN:
1439-0477
,
0342-3026
DOI:
10.1515/JLM.2008.021
Language:
English
Publisher:
Walter de Gruyter GmbH
Publication Date:
2008
detail.hit.zdb_id:
2081704-6
detail.hit.zdb_id:
2909042-8
SSG:
15,3
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