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Eur J Surg Oncol. 2018 Oct;44(10):1539-1541. doi: 10.1016/j.ejso.2018.06.013. Epub 2018 Jun 23.

Triage for selection to colonoscopy?

Author information

1
Center for Surgical Research, Department of Surgical Gastroenterology, Hvidovre Hospital, Hvidovre, Denmark.
2
Center for Surgical Research, Department of Surgical Gastroenterology, Hvidovre Hospital, Hvidovre, Denmark; Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. Electronic address: h.j.nielsen360@gmail.com.
3
Bispebjerg Hospital, Copenhagen, Denmark.
4
Herlev Hospital, Herlev, Denmark.
5
Herning Hospital, Herning, Denmark.
6
Hillerød Hospital, Hillerød, Denmark.
7
Holstebro Hospital, Holstebro, Denmark.
8
Horsens Hospital, Horsens, Denmark.
9
Randers Hospital, Randers, Denmark.
10
Skejby Hospital, Aarhus, Denmark.
11
Silkeborg Hospital, Silkeborg, Denmark.
12
Viborg Hospital, Viborg, Denmark.

Abstract

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 led to focus, however, 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 heath budgets and in particular, the subjects, who do not need an unnecessary, unpleasant and risk-associated bowel examination.

KEYWORDS:

Biomarkers; Blood test; Colonoscopy; Colorectal cancer; Screening; Triage

PMID:
30251643
DOI:
10.1016/j.ejso.2018.06.013
[Indexed for MEDLINE]

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