New Research Concludes Computed Tomography Colonography an Acceptable Alternative to Colonoscopy for Surveillance of High-Risk Individuals

Article:

Diagnostic accuracy of computed tomographic colonography for the detection of advanced neoplasia in individuals at increased risk of colorectal cancer

Authors:

Regge D, Laudi C, Galatola G, et al.

Publication:

Journal of American Medical Association, 2009;301(23):2453-2461.

Summary:

In a multi-center study, Dr. Daniele Regge and her team examined a cohort of 937 patients, each of whom had one or more of the following three determining factors that may increase a patient’s susceptibility to colorectal cancer: the existence of advanced neoplasia in a first-degree relative, a personal history of colorectal adenoma, or a positive result from a fecal occult blood test (FOBT). In measuring the sensitivity and accuracy of CT colonography, researchers recruited at-risk patients to undergo CT colonography in the morning, followed by a standard colonoscopy later in the day.

Compared with unblinded colonoscopy as “the gold standard,” Regge and her team found that CT colonography exhibited 85% sensitivity and 88% specificity in detecting advanced colorectal neoplasia. As a result of their findings, the researchers decided “that CT colonography may be an acceptable alternative to colonoscopy in patients with a history of adenoma and those with a family history of colorectal neoplasm.”

According to the University of Michigan’s Emily Finlayson, MD, MS, CT colonography is not only beneficial due to its noninvasive nature – it also greatly reduces the risk of adverse events, half of which occur due to sedation (which CT colonography does not require).

“While the use of CT colonography as a screening and surveillance modality is still a matter of debate,” said Finlayson, “the study by Regge et al suggests that CT colonography may be an acceptable alternative to colonoscopy in patients with a history of adenoma and those with a family history of colorectal neoplasm.”

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