gms | German Medical Science

With over 66 000 new cases per year colorectal cancer (CRC) is the most frequent cancer in Germany. Due to its slow development from detectable and curable precancerous lesions, screening for CRC has a high potential to reduce morbidity and mortality of the disease. Colonoscopy is the most reliable early detection method, but it is used as a primary screening method by a minority of eligible people only. Less invasive tests, such as stool tests, might help to reach additional proportions of the target population. Despite its proven efficacy for reducing CRC incidence and mortality, the widely used fecal occult blood test (FOBT) has important limitations, above all its low sensitivity. First results concerning performance of new stool tests are encouraging, but evidence is mostly restricted to small-scale investigations in the clinical setting. Furthermore, the potential of early detection based on blood samples starts to become a focus of current research. The offer of colonoscopy as a primary screening tool in Germany provides a unique opportunity for a concomitant evaluation of the use of novel tests for CRC screening. We set up a study (BLITZ, “Begleitende Evaluierung innovativer Testverfahren zur Darmkrebs-Früherkennung”) in the Rhine-Neckar-region to assess the ability of novel tests to predict abnormal colonoscopic findings in a large sample of symptomatic people undergoing screening colonoscopy. Starting in January 2006, we aim to recruit 3,000 participants through a network of 20 gastroenterological practices. Stool and blood samples are collected from participants prior to preparation for colonoscopy. Furthermore, patients are asked to fill out a standardized questionnaire, and colonoscopy and histology reports are collected. By this presentation, we would like to inform the scientific and clinical community about this new study which will be open to collaborations with partners working on the development of novel markers for CRC screening. A preliminary list of stool tests to be evaluated besides the standard FOBT include tests for tumor M2 PK, calprotectin, and hemoglobin (immunological test). In addition, stool and blood samples are stored to allow for evaluation of other potentially promising novel tests.