Triage for selection to colonoscopy?

Eur J Surg Oncol. 2018 Oct;44(10):1539-1541. doi: 10.1016/j.ejso.2018.06.013. Epub 2018 Jun 23.


Implementation of population screening for colorectal cancer by direct colonoscopy or follow-up colonoscopy after a positive fecal blood test has challenged the overall capacity of bowel examinations. Certain countries are facing serious colonoscopy capacity constraints, which have led to waiting lists and long-time latency of follow-up examinations. Various options for improvement are considered, including increased cut-off values of the fecal blood tests. Results from major clinical studies of blood-based, cancer-associated biomarkers have led to focus, however, on a triage concept for improved selection to colonoscopy. The triage test may include subject age, concentration of hemoglobin in a feces test and a combination of certain blood-based cancer associated biomarkers. Recent results have indicated that triage may reduce the requirements for colonoscopy by around 30%. Such results may be advantageous for the capacity, the heath budgets and in particular, the subjects, who do not need an unnecessary, unpleasant and risk-associated bowel examination.

Keywords: Biomarkers; Blood test; Colonoscopy; Colorectal cancer; Screening; Triage.

MeSH terms

  • Age Factors
  • Biomarkers / blood
  • Colonoscopy*
  • Colorectal Neoplasms / blood
  • Colorectal Neoplasms / diagnosis*
  • Early Detection of Cancer*
  • Feces / chemistry
  • Hemoglobins / analysis
  • Humans
  • Occult Blood
  • Patient Selection*
  • Triage*


  • Biomarkers
  • Hemoglobins