Globally, more than 1 million people get colorectal cancer every year. This dangerous disease results in about 715,000 deaths annually. It is the fourth most common cause of cancer death. In Germany, colon cancer is the second most common cancer disease.

While the number of tumor cases, unfortunately, increases year by year, the prevalence of colorectal cancer has fortunately declined. Only in Germany, the incidence of new cancers of the large intestine and the rectum decreased by about 16 percent between the years 2003 and 2013. Moreover, the number of those who die because of colorectal cancer is decreasing, too. This pleasing trend has one main reason: since 2002, every legally insured person over the age of 55 has been entitled to a precautionary colonoscopy testing, which is called screening program. Gastroenterologists such as Dr. Joachim Mössner, the Head of the Gastroenterology and Rheumatology Clinic at the University Hospital Leipzig, also detects benign polyps (small abnormal growth of tissue) and removes them before they may become malignant tumors.

"Colonoscopy is the most important diagnostic method for detecting colorectal cancer," says Prof. Mössner. "Only then the precancerous lesions, such as polyps, can be easily removed. A new diagnostic tool called the fecal immunochemical test (FIT test) is an interesting method to find invisible blood in the stool, which is very important for early cancer detection. This test also belongs to the legal screening program and, in contrast to its predecessors, has several advantages. Probably the biggest one for the patient is that there is no need to keep a diet prior to the stool examination. The FIT test can distinguish the human blood from the animal, so that it is less susceptible to interference, for example, if a hamburger bun was eaten the day before the examination."

This new test is able to recognize colon cancer almost as much precise as colonoscopy. However, according to Prof. Mössner, it is not fully clear, whether it is better to convince patients to colonoscopy or to the FIT test. In the colonoscopy, polyps are more often detected, which can then be rapidly removed with the help of endoscopy. The patient is often saved due to a surgery. “In the end, the most important for us is the percentage of patients’ participation. From the economical point of view, FIT test is also much cheaper than colonoscopy. However, I don't think that there is a competition for the replacement between the invasive colonoscopy and non-invasive stool test. The FIT test increases the acceptance and participation in the colorectal cancer screening, perhaps because it is more comfortable for the patient."

The FIT test is recommended for all people at the age of 50 to 54 once a year. Most health insurance companies take over the costs. However, if the results of the FIT test become positive, the patient must undergo colonoscopy for the further evaluation. From the age of 55, the test should be done only once in two years as everyone is entitled to a free colonoscopy screening program from the age of 55. From this moment, if the doctors do not find any noticeable changes in the outpatient examination, the colonoscopy doesn’t need to be repeated until ten years later.

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