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Noninvasive testing for colorectal cancer: a review
Daniel L Ouyang1, Joseph J Chen, Robert H Getzenberg
1Department of Medicine, Stanford University School of Medicine, Stanford, California, USA.
The American Journal of Gastroenterology
|June 3, 2005
Summary
Noninvasive biomarkers are crucial for early colorectal cancer (CRC) detection due to poor endoscopic screening rates. Current options include fecal occult blood tests and DNA testing, with emerging serum-based markers showing future promise.
Area of Science:
- Oncology
- Biomarker Discovery
- Gastroenterology
Background:
- Colorectal cancer (CRC) is a leading cause of cancer mortality in the US.
- Endoscopic screening for CRC is underutilized, necessitating alternative detection methods.
- A significant portion of the population avoids endoscopic screening, highlighting the need for noninvasive biomarkers.
Purpose of the Study:
- To review existing noninvasive screening markers for early CRC detection.
- To discuss emerging biomarkers undergoing preliminary evaluation.
- To introduce and explain promising future noninvasive CRC detection markers.
Main Methods:
- A comprehensive literature search was conducted using MEDLINE/PubMed.
- Relevant publications on CRC early detection markers were identified.
- Cited publications were secondarily reviewed to ensure thoroughness.
Main Results:
- Stool-based tests, including fecal occult blood and DNA mutation analysis, are the most advanced noninvasive markers.
- Abnormal mucin detection in stool has also been investigated.
- Early research into serum-based markers includes proteomics, nuclear matrix proteins, and serum DNA testing.
Conclusions:
- Guaiac-based fecal occult blood testing (FOBT) is a cost-effective method for reducing CRC mortality.
- Immunochemical FOBT improves compliance and specificity but is more expensive.
- Fecal DNA testing offers higher sensitivity but is limited by cost for widespread screening.
- Rectal mucin testing requires further validation.
- Serum-based markers represent a promising but nascent area for future CRC detection.