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Joint Asian Pacific Association of Gastroenterology (APAGE)-Asian Pacific Society of Digestive Endoscopy (APSDE) clinical practice guidelines on the use of non-invasive biomarkers for diagnosis of colorectal neoplasia

Chan FKL 1 , Wong MCS 2 , Chan AT 3 , East JE 4 , Chiu HM 5 , Makharia GK 6 Show all authors , Weller D 7 , Ooi CJ 8 , Limsrivilai J 9 , Saito Y 10 , Hang DV 11 , Emery JD 12 , Makmun D 13 , Wu K 14 , Ali RAR 15 , Ng SC 16

Affiliations 

  • 1 Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
  • 2 JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, People's Republic of China
  • 3 Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
  • 4 Translational Gastroenterology Unit, Nuffield Department of Medicine, Oxford NIHR Biomedical Research Centre, John Radcliffe Hospital, University of Oxford, Oxford, UK
  • 5 Department of Internal Medicine, College of Medicine, National Taiwan University Hospital, Taipei, Taiwan
  • 6 Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
  • 7 Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK
  • 8 Duke - NUS Medical School, Singapore
  • 9 Internal Medicine, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand
  • 10 Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan
  • 11 Hanoi Medical University, Hanoi, Vietnam
  • 12 Department of General Practice, The University of Melbourne Faculty of Medicine Dentistry and Health Sciences, Melbourne, Victoria, Australia
  • 13 University of Indonesia, Depok, Indonesia
  • 14 Xijing Hospital of Digestive Diseases, Xijing Hospital, Xian, China siewchienng@cuhk.edu.hk draffendi@ppukm.ukm.edu.my kaicwu@fmmu.edu.cn
  • 15 School of Medical and Life Sciences Sunway University, Selangor, Malaysia siewchienng@cuhk.edu.hk draffendi@ppukm.ukm.edu.my kaicwu@fmmu.edu.cn
  • 16 Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, People's Republic of China siewchienng@cuhk.edu.hk draffendi@ppukm.ukm.edu.my kaicwu@fmmu.edu.cn
Gut, 2023 Jul;72(7):1240-1254.
PMID: 37019620 DOI: 10.1136/gutjnl-2023-329429

Abstract

Screening for colorectal cancer (CRC) is effective in reducing CRC related mortality. Current screening methods include endoscopy based and biomarker based approaches. This guideline is a joint official statement of the Asian Pacific Association of Gastroenterology (APAGE) and the Asian Pacific Society of Digestive Endoscopy (APSDE), developed in response to the increasing use of, and accumulating supportive evidence for the role of, non-invasive biomarkers for the diagnosis of CRC and its precursor lesions. A systematic review of 678 publications and a two stage Delphi consensus process involving 16 clinicians in various disciplines was undertaken to develop 32 evidence based and expert opinion based recommendations for the use of faecal immunochemical tests, faecal based tumour biomarkers or microbial biomarkers, and blood based tumour biomarkers for the detection of CRC and adenoma. Comprehensive up-to-date guidance is provided on indications, patient selection and strengths and limitations of each screening tool. Future research to inform clinical applications are discussed alongside objective measurement of research priorities. This joint APAGE-APSDE practice guideline is intended to provide an up-to-date guide to assist clinicians worldwide in utilising non-invasive biomarkers for CRC screening; it has particular salience for clinicians in the Asia-Pacific region.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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