Colorectal cancer screening: the role of CT colonography

Cesare Hassan, A Laghi, F Iafrate, M Rengo

Risultato della ricerca: Contributo in rivistaArticolo in rivista

18 Citazioni (Scopus)

Abstract

Computed tomography colonography (CTC) in colorectal cancer (CRC) screening has two roles: one present and the other potential. The present role is, without any further discussion, the integration into established screening programs as a replacement for barium enema in the case of incomplete colonoscopy. The potential role is the use of CTC as a first-line screening method together with Fecal Occult Blood Test, sigmoidoscopy and colonoscopy. However, despite the fact that CTC has been officially endorsed for CRC screening of average-risk individuals by different scientific societies including the American Cancer Society, the American College of Radiology, and the US Multisociety Task Force on Colorectal Cancer, other entities, such as the US Preventive Services Task Force, have considered the evidence insufficient to justify its use as a mass screening method. Medicare has also recently denied reimbursement for CTC as a screening test. Nevertheless, multiple advantages exist for using CTC as a CRC screening test: high accuracy, full evaluation of the colon in virtually all patients, non-invasiveness, safety, patient comfort, detection of extracolonic findings and cost-effectiveness. The main potential drawback of a CTC screening is the exposure to ionizing radiation. However, this is not a major issue, since low-dose protocols are now routinely implemented, delivering a dose comparable or slightly superior to the annual radiation exposure of any individual. Indirect evidence exists that such a radiation exposure does not induce additional cancers.
Lingua originaleEnglish
pagine (da-a)3987-3994
Numero di pagine8
RivistaWorld Journal of Gastroenterology
Volume16
Stato di pubblicazionePubblicato - 2010
Pubblicato esternamenteYes

Keywords

  • Colonography, Computed Tomographic
  • Colorectal Neoplasms
  • Cost-Benefit Analysis
  • Early Detection of Cancer
  • Humans
  • Mass Screening
  • Patient Compliance
  • United States

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