Division of Preventive Oncology, National Center for Tumor Diseases/German Cancer Research Center (DKFZ), Im Neuenheimer Feld 460, 69120 Heidelberg, Germany.
Expert Rev Mol Diagn. 2011 Jul;11(6):605-16. doi: 10.1586/erm.11.41.
Owing to its slow development from removable precursor lesions and early cancer stages with good prognosis, screening for colorectal cancer holds potential to reduce both the incidence and mortality of the disease. While sigmoidoscopy only detects left-sided neoplasia, there is accumulating evidence that colonoscopy is also more effective in protecting from neoplasia in the left versus the right colon and rectum. In this context, it is an important question whether the sensitivity of the most common noninvasive screening tool for colorectal cancer, fecal occult blood testing (FOBT), also differs for left- versus right-sided neoplasia. Therefore, we systematically searched the literature for prospective screening studies conducted in average-risk adults that performed FOBT (immunochemical and/or guaiac-based) and colonoscopy among all participants, and reported site-specific sensitivities of FOBT for advanced colorectal neoplasia. Most of the seven included studies showed a higher sensitivity of FOBT for advanced neoplasia in the left versus right colon, but this finding needs to be confirmed since the available literature is scarce and not entirely consistent.
由于结直肠癌从可切除的前体病变和预后良好的早期癌症阶段发展缓慢，因此筛查结直肠癌具有降低疾病发病率和死亡率的潜力。虽然乙状结肠镜检查仅能检测左侧肿瘤，但越来越多的证据表明，结肠镜检查在预防左侧与右侧结肠和直肠肿瘤方面也更有效。在这种情况下，一个重要的问题是，最常见的非侵入性结直肠癌筛查工具粪便潜血检测（FOBT）对左侧与右侧肿瘤的敏感性是否也不同。因此，我们系统地检索了文献，以寻找在普通风险成年人中进行的前瞻性筛查研究，这些研究对所有参与者进行了 FOBT（免疫化学和/或愈创木脂基）和结肠镜检查，并报告了 FOBT 对结直肠高级别肿瘤的特定部位敏感性。纳入的 7 项研究中的大多数都表明 FOBT 对左半结肠高级别肿瘤的敏感性更高，但这一发现需要得到证实，因为现有文献有限且并不完全一致。
