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Colon cancer screening: Immunological tests are superior
Date:5/28/2013

For early detection of colorectal (colon) cancer, statutory health insurance in Germany offers a fecal occult blood test free of charge to all insured persons starting at 50 years of age. In addition, those 55 or older are entitled to an endoscopic examination of the colon (colonoscopy). Colonoscopy identifies precancerous lesions with a high level of exactitude. Nevertheless, only about 20-30 percent of those eligible actually take advantage of the screening examination. "Therefore, fecal occult blood tests are important, because they help us reach more people. People are much more willing to have a simple laboratory test. Hence it is all the more important for these tests to provide valuable results," says Professor Hermann Brenner from the German Cancer Research Center (Deutsches Krebsforschungszentrum, DKFZ).

The test covered by health insurance is based on the detection of enzymatic activity in fecal occult blood (a "stool guaiac test"). For several years now, immunological testing methods using antibodies to detect hemoglobin in stool samples have also been available. These tests are regarded as more sensitive; i.e., they are believed to detect more tissue abnormalities. Until now, however, the two methods have only been compared in a few small-scale studies.

Hermann Brenner and his coworker Sha Tao have now directly compared the two methods in a large-scale study for the first time. 2,235 participants who underwent colon cancer screening colonoscopies between 2005 and 2009 provided stool samples immediately prior to the examination. These were tested for occult blood using both methods. Subsequently, the DKFZ researchers analyzed the test results by comparing them with the results from colonoscopies.

The enzyme-based test detected one third of all colon cancer cases, about nine percent of advanced precancerous lesions (adenomas), and about five percent of early precancerous lesions. The specificity was slightly over 95 perce
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Contact: Dr. Sibylle Kohlstädt
s.kohlstaedt@dkfz.de
Helmholtz Association of German Research Centres
Source:Eurekalert

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