Colorectal cancer: Which cancer test is safest?

Early detection can save lives
Colorectal cancer is one of the most common cancers in Germany. Every year around 26,000 people die in this country. The chances of a cure depend heavily on how early the cancer and its precursors are discovered. Since this year, new immunological tests for blood in the stool have been used. Scientists from the German Cancer Research Center( DKFZ) have now compared nine of these tests. They found that all provide comparable results.

For several months, new immunological tests for blood in stool have been used in Germany for colorectal cancer screening. Researchers have now compared several of these tests and found that all give very similar results.(Image: Alex /

Immunological Testing Investigates
Colorectal cancer screening has become simpler and more reliable this year. Immunological tests detect if there is blood hemoglobin in the stool. This serves as an indication of whether a patient is suffering from colon cancer or a colorectal cancer precursor.

The fact that the immunological tests have replaced the less specific HemOccult test is largely due to the work of Hermann Brenner from the DKFZ, the institute writes in a statement.

There are currently many different immunological tests on the market.

"So far, it was unclear whether and to what extent there are differences between the tests offered," says the epidemiologist Brenner. That's why, together with his employees, he has made nine tests a direct comparison.

tests discover the vast majority of colorectal cancers
Its result: All nine tests detect the vast majority of colorectal cancers and also many colorectal cancer precursors. If one follows the manufacturer's instructions as of which value a test is to be regarded as positive, then the frequencies of positive results differ greatly.

However, when the scientists adjusted the thresholds in the evaluation, all tests yielded very similar results.

"In this paper, we present, for the first time and worldwide, a one-off, direct comparison of the diagnostic value of a large number of quantitative tests in the same large group of investigators," Brenner said.

Nationwide recommendations for individual test thresholds could be derived from these figures.

Lower-threshold Screening Survey
"With this work, Brenner and colleagues give very specific recommendations on how to further improve the early detection of colorectal cancer," emphasized Michael Baumann, Chairman of the DKFZ.

"It's important to provide people with a low-threshold screening test in addition to the more sophisticated colonoscopy, which remains the gold standard in colorectal cancer screening."

Five of the nine tests require laboratory analysis. The remaining four tests can be carried out and evaluated directly in the primary care and urological practice.

Even the test, which is evaluated using a smartphone app, provided reliable results - at least when performed by trained personnel.

The researchers published their findings in the journal Gastroenteroolgy.

Third most common cancer worldwide
According to the DKFZ, colon cancer is the third most common cancer worldwide. About 1.4 million people get sick each year and 700,000 die. Even with colon cancer, the sooner you discover it, the better. Early detection can save lives.

Colonoscopy is the safest method of detecting colon cancer and its precursors. But when should you go for colonoscopy? The investigation is recommended if the family has already had colon cancer cases.

In addition, all German statutory health insurance from the age of 55 have the right to colonoscopy.

According to experts, however, it would make sense to aim at a new age limit and to recommend the investigation from the age of 50 years.

Unfortunately, the test procedure is laborious and many patients are shy of it. Only 20 to 30 percent of the beneficiaries participate.

New immunological test procedures, which have been paid by the health insurance companies since April of this year, are intended to help motivate more people to have a check-up.

"It works very well for our neighbors in the Netherlands," explained Brenner. There people are invited to participate with a personal letter - the test will be sent directly to you. As a result, attendance rates of over 60 percent can be achieved. Germany is still far from it.(ad)

Nine immunological tests for colorectal cancer screening yield very similar results
According to health experts, colon cancer is one of the most common cancers in Germany. The chances of a cure depend heavily on how early the cancer is discovered. German researchers have now taken a closer look at the effectiveness of various immunological tests for colorectal cancer screening and found that they all give very similar results.

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