Home Medizin Der Bluttest weist eine hohe Genauigkeit bei der Erkennung von Darmkrebs auf

Der Bluttest weist eine hohe Genauigkeit bei der Erkennung von Darmkrebs auf

von NFI Redaktion

A new study has found that a cell-free DNA blood test (cfDNA) aimed at detecting abnormal DNA signals in individuals at average risk for colorectal cancer (CRC) correctly identified most individuals with confirmed CRC. The cfDNA blood test showed a sensitivity of 83% for CRC, a specificity of 90% for advanced neoplasms, and a sensitivity of 13% for advanced cancer precursors. This test compares favorably to other non-invasive screening methods with a sensitivity ranging from 67% to 94% for CRC and 22% to 43% for advanced cancer precursors.

Lead author William Grady, MD, director of the Gastrointestinal Cancer Prevention Program at the Fred Hutchinson Cancer Center in Seattle, Washington, stated that these results represent a promising step towards developing more convenient tools for early detection of CRC when it can be more effectively treated. The study was published online on March 14 in The New England Journal of Medicine.

The study, called ECLIPSE, conducted by Grady and colleagues, compared the sensitivity and specificity of a cfDNA blood test (Shield, Guardant Health) with colonoscopy, the gold standard for colorectal cancer screening. The Shield test was designed to detect CRC based on genomic alterations, abnormal methylation status, and fragmentomic patterns indicating „abnormal signal detected“. Similar blood tests, known as „liquid biopsy“ tests, are also being developed for other emerging cancer screening purposes.

The study included 7,861 individuals at average risk for CRC who underwent routine screening with colonoscopy at 265 sites across the United States. Of those, 54 out of 65 (83.1%) participants with confirmed CRC by colonoscopy had a positive cfDNA blood test. However, 11 participants (16.9%) with CRC had a negative test result.

The cfDNA blood test identified 42 out of 48 CRC cases in stages I, II, or III, with a sensitivity of 87.5%, including 65% for stage I, 100% for stage II, and 100% for stage III. The test also identified all 10 stage IV CRC cases. There were no significant differences in sensitivity for CRC based on primary tumor location, tumor histological grade, or demographic characteristics.

Among participants without advanced colorectal neoplasia on colonoscopy, 89.6% had a negative cfDNA blood test and 10.4% had a positive test. The specificity was 89.9% for those with a negative colonoscopy. Among 1116 participants with advanced precancerous lesions identified as the most advanced lesion on colonoscopy, the cfDNA blood test was positive in 147, indicating a sensitivity of 13.2% for advanced precancerous lesions.

While the blood test shows similar sensitivity to stool-based tests for CRC, it is less accurate than colonoscopy, which remains the current gold standard for CRC screening. Grady emphasized the importance of offering a variety of screening options to individuals who may otherwise decline current screening options.

Colorectal cancer is a significant health concern in the United States, with rising incidence rates among individuals under 50 years old. Early detection of CRC can lead to better outcomes for patients, making effective blood-based testing potentially valuable, especially for those not currently undergoing screening.

Moving forward, additional research is needed to address the challenges of implementing blood-based tests for effective cancer detection. Communication with patients will be crucial in ensuring understanding and acceptance of these new screening options. It is important to balance patient enthusiasm for blood-based tests with their lower performance compared to established tests already on the market.

In conclusion, while blood-based tests for CRC show promise, they are not intended to replace colonoscopy. The results of this study are an exciting development in cancer screening, offering an additional option for patients who may decline other screening methods. Further research and support will be necessary to optimize the use of blood-based tests for effective cancer detection and prevention.

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