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Title: CT Colonography a Viable Colorectal Cancer Screening Option to Colonoscopy
URL: http://www.pslgroup.com/dg/22CA1A.htm
Doctor's Guide
September 17, 2008

BETHESDA, Md -- September 17, 2008 -- The American Gastroenterological Association (AGA) Institute considers colonoscopy the definitive test for colorectal cancer screening and prevention, but computed tomographic (CT) colonography may be another acceptable technology for colorectal cancer screening.

The report is published in the September 18 issue of the New England Journal of Medicine.

Although colonoscopy is the preferred method of screening, the study suggests that CT colonography could increase screening rates in eligible patients who have not participated in other colorectal cancer screening procedures.

The study results showed that CT colonography detected 90% of large polyps (>10 mm), a rate on par with traditional colonoscopy. However, CT colonography was less sensitive for small polyps (5 mm - 9 mm), with detection rates as low as 65% (5 mm).

The need to define the natural history and biological significance of small polyps is central to refining colorectal cancer screening, irrespective of modality. This study did not investigate diminutive polyps (<5 mm) and the ability of CT colonography to detect flat lesions remains unanswered.

The study investigators were highly trained in CT colonography, perhaps increasing the accuracy rate of the test. Therefore, standardised, rigorous training and proper technique are essential to ensuring that CT colonography achieves appropriate sensitivity, specificity, and performance.

Physicians must also help patients understand the pros and cons of the available colorectal cancer screening tests. Despite the perception that CT colonography is less invasive than traditional colonoscopy, it requires similar bowel preparation as for a colonoscopy. Patients also need to understand that if a polyp is found, it must be removed through a subsequent colonoscopy.

In addition, patients also need to understand that for most people colorectal cancer screening is not a one-time event and that interval examinations are recommended.

SOURCE: American Gastroenterological Association

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