Neue Testverfahren in der Präventionsstrategie des kolorektalen Karzinoms

Zusammenfassung

Zu den neuen Verfahren beim Darmkrebs-Screening zählen die immunologischen Stuhlbluttests (iFOBT), DNA-Stuhltests, Blut-/ und Serummarker sowie darüber hinaus visualisierende Verfahren wie CT-/MRT, Kolon-Kapsel und Oncoscope. Aktuell haben die immunologischen Stuhltests die besten Karten, nach Festlegung von standardisierten Qualitätskriterien in das Früherkennungsprogramm der gesetzlichen Krankenversicherung aufgenommen zu werden. Molekulare Blut- und Serummarker sind noch in der Evaluationsphase. Ihre Bestimmung und ihr Preis sind aktuell noch ein Hindernis für ein Massen-Screening. Die CT-Kolonographie hat exzellente Detektionsraten, scheidet in Deutschland aber wegen der Strahlenbelastung als Screening-Verfahren derzeit aus. Die MR-Kolonographie kommt ohne Strahlen aus, steckt aber noch in der Entwicklungsphase. Die Kolon-Kapsel hat möglicherweise das Potenzial, ein guter diagnostischer Filter zu werden. Durch diese neuen Entwicklungen lassen sich die Teilnahmeraten beim Screening wahrscheinlich nur marginal steigern. Somit sind zukünftig auch politische Strategien zu fordern, das derzeit vorliegende opportunistische Screening umzustellen.

Schlüsselwörter

kolorektales Karzinom - Karzinom-Prävention - immunologische Stuhltests - molekulare Marker

Keywords

colorectal cancer - cancer prevention - immunological fecal occult blood tests - molecular marker

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