title: Point-of-care testing in the diagnosis of gastrointestinal cancers: current technology and future directions.
abstract: 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.
authors.affiliation: Jeremy R Huddy, Melody Z Ni, Sheraz R Markar, George B Hanna, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, South Wharf Road, W2 1NY London, United Kingdom.
authors.forename: Jeremy R
authors.initials: JR
authors.lastname: Huddy
authors.affiliation: Jeremy R Huddy, Melody Z Ni, Sheraz R Markar, George B Hanna, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, South Wharf Road, W2 1NY London, United Kingdom.
authors.forename: Melody Z
authors.initials: MZ
authors.lastname: Ni
authors.affiliation: Jeremy R Huddy, Melody Z Ni, Sheraz R Markar, George B Hanna, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, South Wharf Road, W2 1NY London, United Kingdom.
authors.forename: Sheraz R
authors.initials: SR
authors.lastname: Markar
authors.affiliation: Jeremy R Huddy, Melody Z Ni, Sheraz R Markar, George B Hanna, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, South Wharf Road, W2 1NY London, United Kingdom.
authors.forename: George B
authors.initials: GB
authors.lastname: Hanna
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood / Q000235:genetics; D004252:DNA Mutational Analysis / Q000639:trends; D055088:Early Detection of Cancer / Q000295:instrumentation / Q000639:trends*; D005544:Forecasting; D005770:Gastrointestinal Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000201:enzymology / Q000235:genetics / Q000473:pathology; D006801:Humans; D055432:Metabolomics / Q000639:trends; D009154:Mutation; D009367:Neoplasm Staging; D009780:Occult Blood; D019095:Point-of-Care Systems / Q000639:trends*; D000067716:Point-of-Care Testing / Q000639:trends*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results
chemical_list: D014408:Biomarkers, Tumor
keywords: Cancer-diagnosis; Colorectal cancer; Diagnostic tests; Esophageal cancer; Gastric cancer