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Entitled to new immunological test for improved colorectal cancer screening


Colorectal cancer screening: Starting April, you can claim a new test
New immunological tests for hidden stool blood (iFOBT) are intended to significantly improve early detection of colorectal cancer. From April 1st, the statutory health insurance companies will cover the cost of a corresponding test as part of the annual cancer screening examinations, to which all statutory health insurers in Germany are entitled from their 50th birthday.

Colorectal cancer early detection is an important factor in terms of therapeutic opportunities. The earlier a disease is discovered, the better the treatment prospects are. Statutory health insurers in Germany are therefore entitled to a preventive medical check-up once a year from their 50th birthday. The examination of possible blood residues in the stool has so far been carried out using so-called enzyme tests. Thanks to the new immunological tests for hidden blood in the stool, early detection should now be significantly better.

New tests detect around twice as many diseases
From now on, immunological tests that detect the blood pigment hemoglobin with antibodies will replace the enzyme tests, reports the German Cancer Research Center (DKFZ). The team headed by Professor Hermann Brenner had already demonstrated the superiority of the new process at the DKFZ in 2013. Both test methods were "subjected to a large-scale direct comparison - with a convincing result: the immunological tests detect around twice as many cancers and around three times as many of the advanced precancerous stages and at the same time provide fewer false positive results," reports Prof. Brenner. The diagnostic informative value of the immunological stool tests is thus significantly higher than that of the enzyme tests.

Colonoscopy continues to be the safest diagnosis
According to the expert, the new immunological tests are less prone to errors because the antibodies react specifically to human hemoglobin. "So the subject does not have to avoid certain foods in advance that could falsify the result," says Brenner. Colonoscopy continues to be the gold standard for early diagnosis, but this offer is only taken up by around 20 to 30 percent of all insured persons of the appropriate age. Therefore, hidden blood tests are also important. "They can also be used to reach people who do not opt ​​for the more complex colonoscopy," says Prof. Brenner.

Increase participation rates in colorectal cancer screening
The importance of the tests for hidden blood in the stool should not be underestimated and "it is all the more important that the laboratory test is then meaningful," emphasizes the DKFZ expert. In order to convince more people to participate in colorectal cancer screening, Professor Brenner is once again talking about the possibility of a personal letter to all insured persons. A recent study showed that "about 60 percent more people take a test for hidden blood if they are informed about colorectal cancer screening and invited to participate with a personal cover letter to which the test is attached," reports the expert . In the Netherlands, such a procedure has now become routine and has achieved participation rates of over 60 percent. In Germany, the attendance rates for colorectal cancer screening are significantly lower.

According to the DKFZ scientist, the call for the introduction of an organized early detection program with personal information and an invitation has been set out in the National Cancer Plan for years. But it has not yet been implemented. It was therefore high time to introduce the invitation procedure nationwide. (fp)

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Video: Colorectal Cancer Screening Folasade P. May, MD, PhD. UCLA Digestive Diseases (January 2022).