Fecal immunochemical tests in patients at increased risk for colorectal cancer—is it prime time yet?
A partir d'une revue systématique de la littérature grise et de la littérature à comité de lecture publiée jusqu'en août 2016 (12 études incluant au total 6 204 participants), cette méta-analyse évalue la sensibilité et la spécificité des tests immunochimiques de recherche de sang occulte dans les selles pour détecter une néoplasie de stade avancé ou un cancer colorectal chez les patients présentant un risque élevé de développer la maladie
Colorectal cancer (CRC) is a common cancer for which effective screening strategies are available; CRC screening strategies aim for both primary prevention (diagnosis and resection of adenomas, the precursors of the majority of CRCs) and secondary prevention (diagnosis and treatment of early-stage, asymptomatic CRC). There are 2 possible approaches: single-step screening with colonoscopy (a simultaneously diagnostic and therapeutic procedure) and 2-step screening with a triage diagnostic test, the positive results of which are followed by colonoscopy. Two-stage strategies aim to reduce the number of individuals with normal colon who undergo unnecessary colonoscopies. Obviously, triage diagnostic tests alone will not alter the natural history of colonic neoplasms or affect clinically important outcomes such as long-term CRC incidence and mortality; such beneficial effects are achieved through colonoscopies triggered by positive triage test results.
JAMA Internal Medicine , commentaire, 2016