Früherkennung – was lässt sich optimieren?

Zusammenfassung

Das kolorektale Karzinom (KRK) bleibt trotz aller Fortschritte in Prophylaxe, Früherkennung und Therapie ein Tumor mit anhaltend hoher Inzidenz und Sterblichkeit. Eine Verbesserung der Früh­erkennungsmaßnahmen ist für die Zukunft un­abdingbar. Neben der Verbesserung der Sensiti­vität und Spezifität der einzelnen Verfahren ist dabei auch die Patientenaufklärung, Compliance und Akzeptanz ein entscheidender Zielparameter. Allerdings bleibt zu beachten, dass eine 100 %-ige Sensitivität mit keiner Methode erreichbar ist, da jede Screeningmethode Vorteile, Limitationen und Nachteile birgt. Unabdingbar erscheint in ­Zukunft aber auch eine individuelle, risikoadaptierte Allokation der Screeningverfahren mit dem Ziel einer größtmöglichen Vorsorgequalität. Zukünftige Screeningstrategien basieren daher neben dem individuellen KRK-Risiko auch auf den Wünschen und Bedürfnissen des zu unter­suchenden Patienten und verbesserten Einladungsstrategien („Organisiertes Darmkrebsscreening“). Denn nur bei einem gut informierten Patienten kann sich die Akzeptanz und Qualität der KRK-Vorsorge verbessern. 

Abstract

Colorectal cancer remains as one of the leading causes of cancer death throughout the world. Major approaches to optimize the screening is based on the improvement of the well-known and evidence based screening methods, i. e. FOBT and ­colonoscopy. However, improvement of patient acceptance, compliance and adherence are im­portant elements of program effectiveness. The mainstay of screening for the future seems to be a more risk adapted and individual approach ­based also on patient wishes and surrounding factors. Every screening program has advantages and limitations, but each program ultimately depends on quality and patient adherence. 

Schlüsselwörter

Kolonkarzinom-Screening - Koloskopie - CT-Kolonografie - Fäkaler Okkult-Bluttest - Patientenakzeptanz

Key words

colon cancer screening - colonoscopy - CT colonography - fecal occult blood test - patient acceptance

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