Colorectal Cancer-Screening - CT Colonography Usage Growing Much Faster Than Colonoscopy

Editor's Choice
Academic Journal
Main Category: Colorectal Cancer
Also Included In: Cancer / Oncology
Article Date: 15 Nov 2011 - 5:00 PST


A study published Online First in The Lancet Oncology shows that CT colonography as an additional primary colorectal cancer-screening test could result in a significantly higher participation in screening programs than conventional colonoscopy.

Colorectal cancer remains the second leading cause of cancer deaths in Europe. The majority of colorectal cancers develop from polyps that are essentially preventable and can be treated.

Although lives are saved by colonoscopy screening by identifying and removing polyps before they become cancerous, participation nevertheless generally remains low. CT colonography however, is less invasive compared with a standard colonoscopy. It does not require sedation and might therefore encourage more people to get screened.

Perry Pickhardt from the University of Wisconsin-Madison, Madison, USA, explains in an accompanying comment:

"The issue with screening for colorectal cancer is not related to the test efficacy per se, but rather to the willingness of patient participation. By offering the additional option of CT colonography for screening, overall patient outcomes will be positively affected by the equivalent (or greater) yield for advanced neoplasia coupled with a decrease in complications and costs."

Researchers lead by Evelien Dekker and Jaap Stoker from the Academic Medical Centre in Amsterdam, and Ernst Kuipers from the Erasmus Medical Center in Rotterdam, The Netherlands decided to compare patient participation and diagnostic yield between screening with conventional colonoscopy and CT colonography.

They invited individuals aged 50-75 years of average-risk from the general population in Amsterdam and Rotterdam, to be randomly selected for colorectal cancer screening either by colonoscopy or by CT colonography.

They observed that participation for screening with CT colonography improved by over 50% compared with conventional colonoscopy, commenting:

"The most probable reason for the significant difference in participation rate is a difference in the expected burden or procedure-related complications."

Findings showed that colonoscopy identified substantially more advanced abnormal growth of cells (neoplasia) per 100 participants compared with CT colonography, however, the overall program yield per invitee for advanced neoplasia was similar for both procedures.

In a concluding statement the researchers say:

"Both techniques can be used for population-based screening for colorectal cancer. Other factors such as cost-effectiveness and perceived burden should be taken into account when deciding which technique is preferable."

Perry Pickhardt agrees in an accompanying comment, saying:

"The additive yields of having both colonoscopy and CT colonography available as primary screening options could have a profound effect on the incidence and mortality of colorectal cancer in the future."

Written by Petra Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

• Additional
• References
• Citations