Less invasive CT-scan based colorectal cancer screening method shows good accuracy.

This release is available in Chinese (see also JAMA and Archives Journals).

Computed tomographic (CT) colonography may offer patients at increased risk of colorectal cancer an alternative to colonoscopy that is less-invasive, is better-tolerated and has good diagnostic accuracy, according to a study in the June 17 issue of JAMA.

Colorectal cancer (CRC) accounts for approximately 210,000 deaths each year in Europe. CT colonography is a procedure in which a detailed picture of the colon is created by an x-ray machine linked to a computer. It has been shown to be sufficiently accurate in detecting colorectal neoplasia (abnormal growth of cells) and is now considered a valid alternative for CRC screening in the general population. Individuals at increased risk of CRC include those with a first-degree family history of advanced colorectal neoplasia and those with positive results from fecal occult blood tests (FOBTs). "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," the authors write.

Daniele Regge, M.D., of the Institute for Cancer Research and Treatment, Candiolo, Turin, Italy, and colleagues assessed the accuracy of CT colonography in detecting advanced colorectal neoplasia in asymptomatic individuals at increased risk of CRC using colonoscopy as the reference standard. The multicenter study included individuals at increased risk of CRC due to either family history of advanced neoplasia in first-degree relatives, personal history of colorectal adenomas (benign tumors), or positive results from FOBTs. Each participant underwent CT colonography followed by colonoscopy on the same day.

Of 1,103 participants, 937 were included in the final analysis: 373 cases in the family-history group, 343 in the group with ...