The potential of new screening tests for colorectal cancer to enhance patient acceptability

Underutilization of colorectal screening stems from patient unacceptability of the tests. We review the characteristics of current screening diagnostic modalities (fecal occult blood testing [FOBT], digital rectal examination, and sigmoidoscopy) which may affect patient acceptability and also assess test sensitivity and specificity. These features are compared with the four new modalities: immunochemical fecal occult blood testing (IFOBT), urinary acetylspermidine testing, Sham's test of rectal mucus, and the structuredness of the cytoplasmic matrix (SCM) in peripheral blood test, the latter two still experimental. We believe that some immediate improvement in patient acceptability and physician enthusiasm can be expected from the use of IFOBT and Shams' test and that features of both urine and SCM blood tests will eventually contribute to widely acceptable colorectal cancer screening techniques.