Published online Apr 14, 2015. doi: 10.3748/wjg.v21.i14.4111
Peer-review started: December 18, 2014
First decision: January 8, 2015
Revised: January 20, 2015
Accepted: February 13, 2015
Article in press: February 13, 2015
Published online: April 14, 2015
Processing time: 118 Days and 13.6 Hours
Point-of-care (POC) tests enable rapid results and are well established in medical practice. Recent advances in analytical techniques have led to a new generation of POC devices that will alter gastrointestinal diagnostic pathways. This review aims to identify current and new technologies for the POC diagnosis of gastrointestinal cancer. A structured search of the Embase and Medline databases was performed. Papers reporting diagnostic tests for gastrointestinal cancer available as a POC device or containing a description of feasibility for POC application were included. Studies recovered were heterogeneous and therefore results are presented as a narrative review. Six diagnostic methods were identified (fecal occult blood, fecal proteins, volatile organic compounds, pyruvate kinase isoenzyme type M2, tumour markers and DNA analysis). Fecal occult blood testing has a reported sensitivity of 66%-85% and specificity greater than 95%. The others are at a range of development and clinical application. POC devices have a proven role in the diagnosis of gastrointestinal cancer. Barriers to their implementation exist and the transition from experimental to clinical medicine is currently slow. New technologies demonstrate potential to provide accurate POC tests and an ability to diagnose gastrointestinal cancer at an early stage with improved clinical outcome and survival.
Core tip: Point-of-care tests are well established. They facilitate real time clinical decision-making and can be cost-effective, reduce in-patient hospital stay and increase patient satisfaction. Faecal Occult Blood has been used internationally since 1993 in screening for colorectal cancer. Six technologies for current or potential point-of-care diagnosis of gastro-intestinal cancer were identified from the literature (faecal occult blood, faecal proteins, volatile organic compounds, pyruvate kinase isoenzyme type M2, tumour markers and DNA analysis). Currently, three have commercially available point-of-care devices. New technologies demonstrate potential to provide accuracy and an ability to diagnose gastrointestinal cancer earlier leading to improved clinical outcome and survival.