Colorectal cancer and polyps: Computed tomographic colonography (virtual colonoscopy) for screening
DISEASE INTERVENTION COMPARISON RESULTS
N Engl J Med. 2008 Sep 18;359(12):1207-17 Diagnostic
IN cancer, colorectal, screening in asymptomatic average risk adults The Use of
computed tomographic colonography (virtual colonoscopy)
As Diagnostic Tool
Is good Than
conventional direct optical colonoscopy
To detect adenomas and cancers > 10 mm: 90% sensibility, 89% specificity
N Engl J Med. 2007 Oct 4;357(14):1403-12 Diagnostic
IN cancer, colorectal, screening in asymptomatic average risk adults The Use of
computed tomographic colonography (virtual colonoscopy)
As Diagnostic Tool
Is equal Than
conventional direct optical colonoscopy
To detect advanced colorectal cancer (3.2% scan VS 3.4% colonoscopy) whilst having much less need of colonoscopy (8%), having no perforation and removing much less polyps.
Gastroenterology. 2004 Nov;127(5):1300-11 Diagnostic
IN cancer, colorectal, screening in asymptomatic average risk adults The Use of
computed tomographic colonography (virtual colonoscopy)
As Diagnostic Tool
Is equal Than
conventional direct optical colonoscopy
To detect colorectal polypes: sensitivity 90%, specificity 92%, positive predictive value 88%, negative predictive value 93.5%, in per-patient analysis.
CMAJ. 2005 Oct 11;173(8):877-81 Randomized Controlled Trial
IN cancer, colorectal, screening in asymptomatic average risk adults The Use of
computed tomographic colonography (virtual colonoscopy)
As Diagnostic Tool
Is worse Than
conventional direct optical colonoscopy
To screening: A CT colonography based strategy plus colonoscopy if abnormalities is less cost-effective: more costly and slight more deaths due to missed adenomas.
N Engl J Med. 2003 Dec 4;349(23):2191-2200 Diagnostic
IN cancer, colorectal, screening in asymptomatic average risk adults The Use of
computed tomographic colonography (virtual colonoscopy)
As Prevention, Primary
Is better Than
conventional direct optical colonoscopy
To Screening: Sensitivity of virtual colonoscopy was 93.8% for polyps at least 10 mm in diameter, 93.9 % for 8 mm and 88.7% for 6 mm. Specificity was 96.0% for polyps at least 10 mm, 92.2% for 8 mm, and 79.6% for 6 mm. 2 malignant polips were detected
JAMA. 2004 Apr 14;291(14):1713-9 Diagnostic
IN cancer, colorectal, screening in asymptomatic average risk adults The Use of
computed tomographic colonography (virtual colonoscopy)
As Prevention, Primary
Is worse Than
conventional direct optical colonoscopy
To detect colorectal polypes: sensitivity of virtual colonoscopy for detecting patients with lesions >= 6 mm: 39% (conventional colonoscopy 99%) Computed tomographic colonography missed 2 of 8 cancers.
Lancet. 2005 Jan 22-28;365(9456):305-11 Diagnostic
IN cancer, colorectal, screening in asymptomatic high risk adults The Use of
computed tomographic colonography (virtual colonoscopy)
As Diagnostic Tool
Is worse Than
conventional direct optical colonoscopy
To detect colorectal polyps > 6mm: virtual CT: sens. 55%, spec. 89%, +LR 5, -LR 0.51 ; coloscopy: sens. 99%, spec. 99.6%, +LR 248, -LR 0.01 ; barium enema: sens. 41%, spec. 82%, +LR 4.8, -LR 0.58.