Ganepola Ganepola Ap, Nizin Joel, Rutledge John R, Chang David H
Ganepola AP Ganepola, Joel Nizin, John R Rutledge, David H Chang, Center for Cancer Research and Genomic Medicine, The Daniel and Gloria Blumenthal Cancer Center, Paramus, NJ 07652, United States.
World J Gastrointest Oncol. 2014 Apr 15;6(4):83-97. doi: 10.4251/wjgo.v6.i4.83.
Early screening for colorectal cancer (CRC) holds the key to combat and control the increasing global burden of CRC morbidity and mortality. However, the current available screening modalities are severely inadequate because of their high cost and cumbersome preparatory procedures that ultimately lead to a low participation rate. People simply do not like to have colonoscopies. It would be ideal, therefore, to develop an alternative modality based on blood biomarkers as the first line screening test. This will allow for the differentiation of the general population from high risk individuals. Colonoscopy would then become the secondary test, to further screen the high risk segment of the population. This will encourage participation and therefore help to reach the goal of early detection and thereby reduce the anticipated increasing global CRC incidence rate. A blood-based screening test is an appealing alternative as it is non-invasive and poses minimal risk to patients. It is easy to perform, can be repeated at shorter intervals, and therefore would likely lead to a much higher participation rate. This review surveys various blood-based test strategies currently under investigation, discusses the potency of what is available, and assesses how new technology may contribute to future test design.
早期筛查结直肠癌是应对和控制全球结直肠癌发病率和死亡率不断上升负担的关键。然而，目前可用的筛查方式严重不足，因为其成本高昂且准备程序繁琐，最终导致参与率较低。人们根本不喜欢做结肠镜检查。因此，开发一种基于血液生物标志物的替代方式作为一线筛查测试将是理想的。这将有助于区分普通人群和高危个体。然后结肠镜检查将成为二级测试，以进一步筛查高危人群。这将鼓励参与，从而有助于实现早期检测的目标，进而降低全球结直肠癌预期上升的发病率。基于血液的筛查测试是一种有吸引力的替代方法，因为它是非侵入性的，对患者风险极小。它易于操作，可以更短的间隔重复进行，因此可能会导致更高的参与率。本综述调查了目前正在研究的各种基于血液的测试策略，讨论了现有方法的效力，并评估了新技术如何可能有助于未来的测试设计。
