Screening
Population studies
Healthy people, without complaints or symptoms, can be tested preventively for (the chance of) developing certain diseases. For example, newborns are examined for hereditary disorders with the help of the heel prick screening, and the colon cancer screening is used to detect a (starting) tumor in the intestine at an early stage in all healthy people in the age category 55-75 years.
Below are examples of the added value of laboratory testing for screening:
Cancer
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Colorectal cancer
iFOB test
The fecal sample collected at home is sent to the laboratory where it's examined through hemoglobin (Hb) detection. Hb presence is demonstrated based on an immunochemical reaction with Hb antibodies. A positive iFOB test result leads to an internal examination (colonoscopy) to investigate the presence of a tumor or precursors (polyps). When colorectal cancer is discovered at an early stage, the chance of cure is greater and treatment less intensive.
Although the iFOB test is effective, work is being done on modifications to discover pre-stages and potentially malignant polyps even earlier. The so-called multitarget iFOB test measures not only hemoglobin but also the proteins calprotectin and serpine.
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Cervical cancer
hrHPV test
The molecular test detects HPV virus infection based on viral DNA. In cervical cancer screening programs, a stepwise screening approach is used. The cervical smear is first tested for hrHPV presence. If the sample is hrHPV-positive, cytological analysis is performed to assess the severity and nature of abnormal cells.
Infections
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Tuberculosis
IGRA blood test
The Interferon Gamma Release Assay (IGRA) can detect Mycobacterium tuberculosis (MTB) in blood. The test is based on the response of MTB to MTB antigens, which leads to the release of interferon gamma. The released interferon gamma is detected using fluorescence technology.
Key advantages of this blood test compared to the skin test (Mantoux) for detecting latent tuberculosis:
- Standardized laboratory procedure
- Unambiguous test results
- No cross-reactivity with tuberculosis vaccine
- Single patient contact (blood draw only)
Gastrointestinal tract and liver
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Liver fibrosis
ELF Test
Early detection of liver fibrosis is possible using the ELF test. The blood test measures three direct markers of fibrosis:
1. hyaluronic acid (HA)
2. procollagen III amino-terminal peptide (PIIINP)
3. Tissue Inhibitor of Matrix Metalloproteinase 1 (TIMP-1)The ELF test can be used as a screening tool for patients with risk factors for liver fibrosis, such as obesity, type 2 diabetes and/or metabolic syndrome. If diagnosed in time, the liver damage can usually be reversed by treatment of underlying cause(s).
Because the ELF score correlates with the severity of liver fibrosis, the test can be used to determine the prognosis of liver disease. A higher score indicates a greater risk of progression to cirrhosis. Iin addition, the test is also suitable for monitoring disease course and treatment response. Repeated measurement of the ELF score allows evaluation of the effects of interventions, such as lifestyle modifications or pharmacotherapy.
Last but not least, the ELF test often eliminates the need for an invasive liver biopsy. The test results support clinical decision-making, leading to more efficient care and potential cost savings.
General Health Screening and Drug Monitoring
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Antibiotic resistance
MDRO screening
Hospital patients are screened for MultiDrug-Resistant Organisms (MDROs) if they have recently been treated in foreign hospitals or work in intensive livestock farming. Patient samples (anal, sputum, wound fluid, or urine) are collected using swabs and analyzed for microorganism presence. Detection and identification utilize PCR technology and DNA analysis. This method determines within 24 hours whether a patient carries an MDRO and identifies the specific type.
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Pregnancy testing
NIPT
NIPT is a blood test that screens for chromosomal abnormalities in the unborn child indicating Down syndrome (trisomy 21), Edwards syndrome (trisomy 18), or Patau syndrome (trisomy 13). The test analyzes cell-free fetal DNA present in maternal blood via the placenta. It measures relative quantities of chromosomes or chromosome segments in maternal plasma, analyzing results through an algorithm. NIPT can be performed starting at ten weeks of pregnancy.
