Zusammenfassung
Hintergrund
Im gesetzlichen Krebsfrüherkennungsprogramm in Deutschland wurde im Jahr 2017 der herkömmliche guajakbasierte Test auf Blut im Stuhl („guaiac-based fecal occult blood test“, gFOBT) durch neuere immunologische Stuhlbluttests („fecal immunochemical tests“, FITs) ersetzt.
Ziel
In dieser Arbeit soll ein Überblick über die Vorteile der FITs gegenüber dem gFOBT gegeben werden.
Material und Methoden
Der Überblick basiert auf einer Zusammenfassung der wichtigsten Ergebnisse der internationalen Literatur.
Ergebnisse
FITs haben gegenüber dem gFOBT eine deutlich höhere Sensitivität für die Entdeckung von Darmkrebs und seinen Vorstufen. Sie weisen spezifisch menschliches Hämoglobin nach, ihre Anwendung ist daher nicht an die Einhaltung spezifischer Diätvorschriften gebunden. Zur Durchführung genügt eine einzelne Stuhlprobe aus einem einzelnen Stuhlgang. Die größere Nutzerfreundlichkeit erhöht die Akzeptanz.
Diskussion
Auf der Basis der vorliegenden Evidenz werden FITs zwischenzeitlich neben der Koloskopie als Mittel der Wahl eines nichtinvasiven Tests in der Darmkrebsvorsorge und -früherkennung empfohlen.
Abstract
Background
In 2017, the guaiac-based fecal occult blood test (gFOBT) which had been offered for colorectal cancer (CRC) screening since 1977 was replaced by fecal immunochemical tests (FITs) for hemoglobin in the German healthcare system.
Objectives
This article aims to summarize evidence on the advantages of FITs over gFOBT in CRC screening.
Materials and methods
Results of key studies from the international literature are summarized.
Results
FITs have higher sensitivity to detect CRC and its precursors than gFOBT. They specifically detect human hemoglobin in stool. Therefore, they are not influenced by dietary factors and do not require dietary restrictions. Only a single fecal sample from one single bowel movement is required. User-friendly application is accompanied by higher adherence rates.
Conclusions
Based on accumulating evidence, FITs are meanwhile widely recommended, besides screening colonoscopy, as the preferred noninvasive method for CRC screening.
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H. Brenner und A. Gies geben an, dass kein Interessenkonflikt besteht.
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J. F. Riemann, Ludwigshafen
S. Zeuzem, Frankfurt am Main
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Brenner, H., Gies, A. Immunologische Stuhlbluttests – welche Verbesserungen gegenüber dem guajakbasierten Test?. Gastroenterologe 14, 6–13 (2019). https://doi.org/10.1007/s11377-018-0290-5
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DOI: https://doi.org/10.1007/s11377-018-0290-5