Petersen Mathias M, Ferm Linnea, Kleif Jakob, Piper Thomas B, Rømer Eva, Christensen Ib J, Nielsen Hans J
Department of Surgical Gastroenterology, Hvidovre Hospital, 2650 Hvidovre, Denmark.
Institute of Clinical Medicine, University of Copenhagen, 2100 Copenhagen, Denmark.
Cancers (Basel). 2020 Sep 12;12(9):2610. doi: 10.3390/cancers12092610.
Implementation of population screening for colorectal cancer by direct colonoscopy or follow-up colonoscopy after a positive fecal blood test has challenged the overall capacity of bowel examinations. Certain countries are facing serious colonoscopy capacity constraints, which have led to waiting lists and long time latency of follow-up examinations. Various options for improvement are considered, including increased cut-off values of the fecal blood tests. Results from major clinical studies of blood-based, cancer-associated biomarkers have, however, led to focus on a Triage concept for improved selection to colonoscopy. The Triage test may include subject age, concentration of hemoglobin in a feces test and a combination of certain blood-based cancer-associated biomarkers. Recent results have indicated that Triage may reduce the requirements for colonoscopy by around 30%. Such results may be advantageous for the capacity, the healthcare budgets and in particular, the subjects, who do not need an unnecessary, unpleasant and risk-associated bowel examination.
通过直接结肠镜检查或粪便潜血试验呈阳性后进行后续结肠镜检查来实施结直肠癌人群筛查，对肠道检查的整体能力提出了挑战。某些国家正面临严重的结肠镜检查能力限制，这导致了等候名单以及后续检查的长时间延迟。人们考虑了各种改进方案，包括提高粪便潜血试验的临界值。然而，基于血液的癌症相关生物标志物的主要临床研究结果促使人们关注一种分流概念，以改进结肠镜检查的选择。分流检测可能包括受试者年龄、粪便检测中的血红蛋白浓度以及某些基于血液的癌症相关生物标志物的组合。最近的结果表明，分流可能会将结肠镜检查的需求减少约30%。这样的结果对于检查能力、医疗保健预算，特别是对于那些不需要进行不必要的、不愉快的且有风险的肠道检查的受试者来说可能是有利的。
