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Journal of Laboratory Medicine

Official Journal of the German Society of Clinical Chemistry and Laboratory Medicine

Editor-in-Chief: Schuff-Werner, Peter

Editorial Board: Ahmad-Nejad, Parviz / Bidlingmaier, Martin / Borucki, Katrin / Karsten, Conrad / Fraunberger, Peter / Ghebremedhin, Beniam / Holdenrieder, Stefan / Kiehntopf, Michael / Klein, Hanns-Georg / Klouche, Mariam / Kohse, Klaus P. / Kratzsch, Jürgen / Luppa, Peter B. / März, Winfried / Nebe, Carl Thomas / Orth, Matthias / Ruf, Andreas / Sack, Ulrich / Steimer, Werner / Weber, Bernard / Wieland, Eberhard / Zettl, Uwe K.

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IMPACT FACTOR 2016: 0.176
5-year IMPACT FACTOR: 0.200

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2567-9449
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Volume 32, Issue 3

Issues

Non-invasive detection of colorectal cancer – do we still need the guaiac-based fecal occult blood test?1

Jürgen Stein
  • 1Department of Gastroenterology and Clinical Nutrition, Katharina Kasper Hospitals, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany and Katharina Kasper Institute of Preventive Medicine and Clinical Nutrition, Frankfurt am Main, Germany
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Stefan M. Loitsch
  • 2Katharina Kasper Institute of Preventive Medicine and Clinical Nutrition, Frankfurt am Main, Germany
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Yogesh Shastri
  • 3Katharina Kasper Institute of Preventive Medicine and Clinical Nutrition, Frankfurt am Main, Germany
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2008-09-23 | DOI: https://doi.org/10.1515/JLM.2008.021et

Abstract

Given the simplicity of the method and how it can be applied, as well as proof that it lowers the mortality rate, fecal occult blood testing (FOBT) is currently the most commonly used screening method for colorectal cancer (CRC). However, the test suffers from poor sensitivity, particularly with respect to detecting early stages, as well as low acceptance among the population. Preliminary data on detecting calprotectin and tumour-M2-PK in the stool indicated that a better screening performance could be expected. But these tests also suffer from low sensitivity in detecting early stages and from poor specificity, thus limiting the usefulness of the tests as a result of high follow-up costs. Recently developed immunological tests (I-FOBT) demonstrate significantly increased sensitivity and specificity. I-FOBTs use antibodies specific to human hemoglobin and are therefore not affected by diet and drugs, leading to improved patient partipication. At present, I-FOBTs seem to be the most cost-effective approach for non-invasive screening. The detection of tumour-DNA in the stool opens up a new era in early diagnosis of colorectal cancer. Small trials have pointed to a very high sensitivity of these methods: 62–91% for colorectal cancer and between 26% and 73% for adenomas, with a very high level of specificity (93–100%). The major drawback of this type of testing, compared with other screening tests available today, is its high cost.

Keywords: calprotectin; colon cancer; colorectal cancer; DNA; fecal occult blood test; M2-PK

About the article

Correspondence: Prof. Dr. Dr. Jürgen Stein, Gastroenterologie/Diabetologie/Ernährungsmedizin, St. Elisabethen-Krankenhaus der Katharina Kasper Kliniken, Lehrkrankenhaus der J.W. Goethe-Universität Frankfurt, Ginnheimer Str. 3, 60487 Frankfurt/Main, Germany Tel.: +49 (69) 79392119/2219 Fax: +49 (69) 7939266


Published Online: 2008-09-23

Published in Print: 2008-05-01


Citation Information: LaboratoriumsMedizin, Volume 32, Issue 3, Pages -–-, ISSN (Online) 1439-0477, ISSN (Print) 0342-3026, DOI: https://doi.org/10.1515/JLM.2008.021et.

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