gms | German Medical Science

27th German Cancer Congress Berlin 2006

German Cancer Society (Frankfurt/M.)

22. - 26.03.2006, Berlin

New stool tests for colorectal cancer screening: a systematic review focusing on performance characteristics and practicalness

Meeting Abstract

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  • corresponding author presenting/speaker Ulrike Haug - Deutsches Krebsforschungszentrum, Abt. Klinische Epidemiologie und Alternsforschung, Heidelberg, Deutschland
  • Hermann Brenner - Deutsches Krebsforschungszentrum, Abt. Klinische Epidemiologie und Alternsforschung, Heidelberg

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPE221

The electronic version of this article is the complete one and can be found online at:

Published: March 20, 2006

© 2006 Haug et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Background: New stool tests may be promising tools for future colorectal cancer (CRC) screening. The aim of this review was to summarize current evidence of performance characteristics and practicalness in a population-based screening setting of recently developed stool tests.

Method: MEDLINE database was searched for relevant articles published until November 2005. Studies were included if they comprised more than 10 cases and more than 10 controls. Details on the study population, on performance characteristics and on the stool collection procedure were taken into account.

Results: Overall, 36 studies, mostly retrospective, were included investigating 21 different stool markers or marker combinations. Underlying study populations were very heterogeneous and mostly very small. Half of the studies reported sensitivity for adenomas in addition to sensitivity for CRC, and less than half of the studies reported sensitivity by tumor stage or by location. Performance characteristics of stool tests varied to a large extent. For most DNA-based markers specificity was about 95% or higher, but sensitivity was mostly low even for invasive CRC. More studies with larger sample sizes were done for protein-based markers, which typically had lower specificity. In most studies, stool samples were frozen within a rather short time period after defecation.

Conclusion: While promising performance characteristics have been reported for some tests, more pervasive evidence from larger, prospectively designed studies is needed which also consider aspects of practicalness. The authors present the design of a corresponding study (BliTz= “Begleitende Evaluierung innovativer Testverfahren zur Darmkrebs-Früherkennung”) aimed at recruiting 3000 participants of screening colonoscopy which they have recently initiated in the Rhine-Neckar-region.