Detektion von kolorektalen Befunden zur Darmkrebsprävention mit immunologischem Stuhltest in verschiedenen Empfindlichkeitsstufen

Abstract

Immunochemical stool blood tests have a significantly higher sensitivity for the detection of advanced neoplasia and colorectal cancer. Based on national and international studies it has been required to include them into the national cancer screening programme in Germany also. The sensitivity (detection limit) can be set by the manufacturer in order to achieve an optimal and balanced result between sensitivity and specificity. The present study was conducted with 639 patients who have undergone both the screening colonoscopy, as well as the immunochemical stool blood test. The test "immoCARE-C" provided by the company CARE diagnostica Laborreagenzien GmbH was used in the study. The test has been evaluated with seven levels of detection limits between 500 ng/mL and 25 ng/mL. The best sensitivity for detection of advanced lesions was demonstrated by a cut-off of 50 ng/mL and 25 ng/mL. The specificity did not fall below 90 %. These positive results lead to considerations to organise a primary access to such tests in the prevention of colorectal cancer as a kind of filter before offering the screening colonoscopy.

Effectiveness, benefit harm and cost effectiveness of colorectal cancer screening in Austria

“…Sensitivities of FIT for advanced adenomas are reported in a recent systematic review ranging from 6 to 44% (median 28%) and for CRC ranging from 25 to 100% (median 88%) [5]. A German study on “immoCARE-C” reported sensitivities depending on cut-off values (37% for polyps > 1 cm cut-off 50, CRC not reported for cut-off 50 and lower) [49]. A recent clinical trial on 9989 patients reported a sensitivity of FIT for advanced adenomas of 23.8 and 73.8% for CRC [33].…”