A fast-track study published online by THE LANCET shows that colonoscopy is the most accurate technique for detecting colon polyps and cancers. Two other procedures often used to detect colon cancer-air-contrast barium enema (ACBE) and the non-invasive 'virtual colonoscopy' Computed tomographic colonography (CTC)-were found to be less reliable.
ACBE and colonoscopy are widely used techniques for detecting colon cancer; CTC is an imaging technique recently introduced for colonic investigation. Don Rockey (Duke University Medical Center, Durham, NC, USA) and colleagues enrolled patients into a study to compare the relative sensitivity of these three techniques.
614 people at risk of colon cancer received ACBE, followed by CTC and colonoscopy 1-2 weeks later. Colonoscopy was highly sensitive, detecting 98% of large (10 mm or greater) and 99% of small (6-9 mm) lesions. Corresponding sensitivity for CTC was 59% and 51%, and for ACBE 48% and 35%, respectively.
Dr Rockey comments: "Our results have important implications for clinicians considering use of colon imaging tests, and potentially for colon cancer screening programmes. As currently undertaken, the sensitivity of colonoscopy is superior to ACBE and CTC. Although the methods used to undertake ACBE are mature, those for CTC are rapidly evolving, and this test will almost certainly undergo significant further advances and improvements. As such, clinicians using this test must stay abreast of performance and patient preference issues."
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