Fecal pyruvate kinase-M2 (tumor M2-PK) measurement: a new screening concept for colorectal cancer.

BACKGROUND Colorectal cancer (CRC) is a disease with major impact on public health and public health costs. Colonoscopy is purportedly the best screening tool for CRC. However, the acceptance by the general population is very poor. Therefore evaluation of additional screening tools is of great interest. PATIENTS AND METHODS The use of M2-PK measurement in the feces has been reported in 6 studies to date. The data of these studies were analysed and critically reviewed. Additionally, 1,906 persons undergoing routine health care check-up provided stool samples for M2-PK measurement. RESULTS The overall sensitivity of M2-PK is 77.9% for CRC. Specificity ranges from 74.3 to 83.3%. Of the 1,906 screened persons, 90.4% had results within the normal range, while 9.6% had elevated results. CONCLUSION Measurement of tumor M2-PK in feces seems to be the most promising tool for CRC screening at the present time. In combination with colonoscopy, this test should hence be recommended for CRC screening programs.