[Fecal oncomarkers in the diagnostics of colorectal cancer]

Colorectal cancer (CRC) presents one of the central problems in modern medicine. In approximately every third patient, colon cancer is revealed at stage IV, which determines the patient's outcome. Early diagnosis is possible only at the pre-clinical stage. To find a cheap and non-invasive diagnostic method which would determine indications to endoscopy is an important task of modern medicine. The authors studied what benefits in CRC diagnostics were provided by fecal calprotectin test and different methods for detection of occult blood in feces as well as combinations of these. The study found that calprotectin test and immunochemical test were more sensitive than hemocult-test for CRC diagnostics (p < 0.05). Immunochemical occult blood test proved to be more sensitive for the detection of polyps or any kind of colon dysplasia (p < 0.05). Hence, despite its relatively high cost, immunochemical occult blood test may be recommended as a non-invasive colorectal cancer marker in individuals with moderate risk, while fetal calprotectin test, being cheap and easily repeatable, may be used for screening only in patients with a high risk of CRC development. Combined application of tests for occult blood and calprotectin in feces makes it possible to increase the sensitivity of the method up to 97.2%, its specificity up to 93.3%, and its effectiveness up to 95.6% in the detection of CRC.