Noninvasive screening tests for colorectal cancer

Area of Science:

• Gastroenterology
• Oncology
• Preventive Medicine

Background:

• Noninvasive screening tests for colorectal cancer (CRC) are crucial for widespread population screening.
• Current noninvasive tests need to be accurate, reliable, affordable, and acceptable to users.

Purpose of the Study:

• To review and summarize the literature on noninvasive CRC screening tests published between 2000 and February 2012.
• To evaluate the effectiveness and cost-effectiveness of various noninvasive CRC screening methods.

Main Methods:

• Systematic literature review of published studies on noninvasive CRC screening tests.
• Analysis of data from 2000 through February 2012, focusing on test performance, effectiveness, and cost-effectiveness.

Main Results:

• Guaiac-based fecal occult blood tests (gFOBTs) have modest reductions in CRC incidence and mortality.
• Fecal immunochemical tests (FITs) demonstrate superior sensitivity and comparable specificity to gFOBTs.
• Emerging biomarkers show potential but require validation in real-world screening settings.

Conclusions:

• FITs are recommended to replace gFOBTs in CRC screening programs.
• Further research on test characteristics, cost-effectiveness, and user appeal is needed for widespread adoption.
• No current noninvasive test fully substitutes for recommended CRC screening methods.