Early Detection of Colon Cancer

SCREENING PROTECTS!

Colon cancer is one of the most common types of cancer in Germany. Each year, around 64,000 people in Germany develop colon cancer, and approximately 26,000 patients die of it. Familial predisposition, fatty food, obesity, smoking, excessive consumption of alcohol, a lack of exercise and increasing age are all risk factors for developing colon cancer.

Colon cancer can usually be detected at an early stage in a screening test, allowing for therapy to be initiated in good time.

The most accurate, and currently most effective method of early detection is currently the colonoscopy, which is performed as a screening test every ten years in men, beginning at age 55. In the procedure, the entire colon is examined.
Intestinal tumours can already be detected at an early stage. During the colonoscopy, the examining physician inserts an endoscope (a flexible thin hose) through the anus into the intestine. With a video camera at the tip of the endoscope, the examiner is able to see the interior of the intestines in detail and take tissue samples through narrow channels in the endoscope. Any polyps that are observed are for the most part removed immediately. Intestinal polyps (adenomas) are regarded as precursors of colon cancer. If there is any familial risk, i.e. if anyone in the family circle has already contracted colon cancer or has died of it, a colonoscopy should already be carried out before the person turns 50.
Unfortunately, many people do not bother to take advantage of this screening option, since it is regarded as unpleasant and troublesome.

From age 50, every patient can undergo a haemoculture test (test for non-visible blood in the stool) every year (every other year starting at age 55 if the option to undergo a colonoscopy is not taken advantage of). The advanced growth of polyps or colon cancer can result in tiny amounts of bleeding that cannot be seen in the stool with the naked eye. During the procedure, the red blood pigment – haemoglobin – is made visible with the help of a chemical reaction. But not all tumours or polyps cause bleeding, and thus they escape detection. Since the result of the test can be influenced by food (raw [red] meat, certain types of vegetables and fruits), a few drugs and any other existing sources of bleeding (e.g. haemorrhoids), this test – even though it is paid for by health insurance companies – is currently performed less and less frequently in the laboratory.

The immunological PreventID stool test shows a level of sensitivity that is considerably higher. This test detects haemoglobin in the stool and does not require any special diets before the stool sample is taken. Medicines do not influence the test result either.

For early detection of intestinal tumours and polyps, the tumour M2-PK test is available. Tumour cells and polyps produce a special enzyme, pyruvate kinase (PK), in a special form. This M2-PK is the characteristic enzyme of all dividing cells, and thus of the tumour cells as well. If a tumour has formed, there will also be an increase in the amount of type M2 isoenzyme. But pyruvate kinase levels can also increase due to inflammatory diseases in the intestine. The test detects the presence of this enzyme in the stool.

The M2-PK enzyme test is a modern biomarker. Identified as the key enzyme in polyps and intestinal tumours, this enzyme is independent of the presence of blood in the stool, thereby eliminating false positive results – particularly with haemorrhoids. Even foodstuff ingredients do not influence the test result. The M2-PK enzyme is therefore specifically for the modified metabolic activity of cells.
This test is easy to use. With just a pea-sized stool sample, the test result is obtained very quickly. The test is very easy to carry out and is very accurate. This procedure can be used to detect more tumours at an early stage. Positive results should, however, be further clarified by a colonoscopy.

A further alternative is provided by the Septin9 test, which only requires a blood sample. The patient does not need to follow any kind of diet prior to this test. Medications do not affect the test result either.
This test is able to detect the presence of a specific marker for colon cancer in a blood sample. Even in the early stages of the disease, colon cancer releases genetic material into the blood. In colon cancer, this affects the Septin9 gene. In contrast to healthy intestinal tissue, the marker Septin9 is present in a modified form. This means that tumour-causing diseases can turn off „good genes” and turn on „bad genes”.
This test is not a genetic test, as it does not detect either genetic defects or genetic disorders. It measures the concentration of the genetically modified Septin9 gene (a „bad gene”) in the blood. The sensitivity of the test is around 70 %. Your doctor receives the result of this test after a week. In the result is positive, the probability that you have colon cancer is high. You now should have a colonoscopy for further clarification.
In known cases of inflammatory bowel disease, however, this test is not reliable enough.

RECOMMENDED LABORATORY TESTS

  • Tumour M2-PK test
  • PreventID test (immunological occult blood test)
  • Septin9 test

The tumour M2-PK test is not yet covered by statutory health insurance.
The Septin9 test is not reimbursed either.

Your doctor will be glad to advise you if you have any further questions about diagnostics.

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