CT Scans May Be Option To Colonoscopy In Identifying Colorectal Cancer
Patients who may be at risk of colorectal cancer may have a less invasive alternative to colonoscopy by use of powerful computed tomographic (CT) scans, according to a new report.
Writing in the June 17 issue of JAMA, Dr. Daniele Regge, of the Institute for Cancer Research and Treatment, Candiolo, Turin, Italy, and colleagues judged the effectiveness of CT colonography by comparing it to colonoscopy, which stood as the reference standard.
Colonoscopy is a simple procedure that involves guiding a camera up through the rectum. Doctors direct the camera while searching for polyps, which can be removed and tested to determine whether or not they are cancerous.
The procedure is regularly recommended for people aged 50 and older.
The CT colonography procedure involves using a powerful x-ray machine to take a detailed picture of the colon.
People who are at an increased risk of colorectal cancer (CRC) have a first-degree family history of colorectal neoplasia and positive results from fecal occult blood tests.
"However, adherence to follow-up colonoscopy in these individuals is suboptimal. Being less invasive and thus more tolerable, CT colonography may increase acceptability and adherence to screening, but little information is available on its performance," researchers wrote.
The study involved 1,103 participants; 937 were placed in the final analysis. Of those, 373 were placed in the family history group, 343 were in the group of personal history of adenomas and 221 were in the group that tested positive from FOBT.
Researchers used both CT colonography and colonoscopy on participants.
CT colonography found 151 of 177 participants with advanced neoplasia 6 mm or larger and correctly classified results as negative for 667 of 760 participants without such lesions.
"CT colonography detected 39 of 41 participants with cancer, including all 3 with diameters of 6 to 9 mm," researchers found.
Researchers said the new findings "suggest a potentially effective use of CT colonography as an alternative to colonoscopy for screening individuals with family history of advanced colorectal neoplasia.”
“Computed tomographic colonography has been shown to be better accepted than colonoscopy and has a negligible risk of serious adverse events; thus, it may help increase the low adherence reported for individuals who are candidates for screening, which is the main negative factor affecting its efficacy in reducing mortality from CRC."
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