The Combined Value of Faecal Haemoglobin and Calprotectin in Diagnosis of Colorectal Cancer in Symptomatic Patients Referred to Colonoscopy

Abstract

Colorectal cancer (CRC) is the third most commonly diagnosed cancer worldwide and has a considerable impact on both the individual and the health care system. The majority of patients with CRC have their initial consultation in primary care [1]. However, the symptoms of CRC often present late. In addition, a vast majority of patients seeking primary care for symptoms associated with CRC (rectal bleeding, a change in bowel habits, diarrhoea, constipation and abdominal pain) are not diagnosed with CRC [2-4]. Therefore, general screening programs among individuals at average risk for CRC, along with guidelines for urgent referral, are implemented widely to reduce mortality of the disease [5,6]. However, there is still a need for improved screening strategies for CRC [4,7,3]. The recommended “gold standard” screening tool for CRC today is endoscopic examination, such as sigmoidoscopy or colonoscopy, but such examinations are resource-demanding, highly costly and inconvenient for the patients [8-11]. The most important factor in screening is patient adherence, and therefore annual faecal occult blood tests have been suggested as an alternative to endoscopy in CRC screening [7]. Analysis of faecal haemoglobin (F-Hb) using either guaiac-based (gFOBT) tests or, more recently, immunological (FIT) tests [12] is commonly used as a primary screening tool, since it requires no preparation, is cost-effective, and relatively convenient for the patient [13]. A positive F-Hb test is an indication of bleeding in the gastrointestinal (GI) tract, which could be caused *Corresponding author: Richard Palmqvist, Department of Medical Biosciences/ Pathology, Umeå University, Sweden. Received Date: September 12, 2019 Published Date: September 17, 2019 Scientific Journal of Gastroenterology & Hepatology Open Access