Can Computed Tomographic Colonography Become a “Good” Screening Test?
Authors: Thomas F. Imperiale
Journal: Annals of Internal Medicine (2005)

Editorials19 April 2005Can Computed Tomographic Colonography Become a “Good” Screening Test?Thomas F. Imperiale, MDThomas F. Imperiale, MDFrom Indiana University Medical Center, Indianapolis, IN 46202-5102.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-8-200504190-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail In the not-too-distant future, I'll have to decide about colorectal cancer screening—as a patient. Despite my first-hand witness to the benefits of colonoscopy, I am seriously considering computed tomographic colonography (CTC) (“virtual colonoscopy”). A recent study of CTC without bowel preparation reported a sensitivity of 90% and specificity of 92% for polyps 8 mm or larger (1). This test appeals to me because I can avoid the preparation, conscious sedation, discomfort, and risk for perforation. These inconveniences collectively cross my threshold for what a “good” screening test should be. A recent multicenter study of CTC reporting a sensitivity of 59% ...References1. Iannaccone R, Laghi A, Catalano C, Mangiapane F, Lamazza A, Schillaci A, et al. Computed tomographic colonography without cathartic preparation for the detection of colorectal polyps. Gastroenterology. 2004;127:1300-11. [PMID: 15520999] CrossrefMedlineGoogle Scholar2. Rockey DC, Paulson E, Niedzwiecki D, Davis W, Bosworth HB, Sanders L, et al. Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet. 2005;365:305-11. [PMID: 15664225] CrossrefMedlineGoogle Scholar3. Smith RA, Cokkinides V, Eyre HJ. American Cancer Society guidelines for the early detection of cancer, 2003. CA Cancer J Clin. 2003;53:27-43. [PMID: 12568442] CrossrefMedlineGoogle Scholar4. Thompson SG, Sharp SJ. Explaining heterogeneity in meta-analysis: a comparison of methods. Stat Med. 1999;18:2693-708. [PMID: 10521860] CrossrefMedlineGoogle Scholar5. Mulhall BP, Veerappan GR, Jackson JL. Meta-analysis: computed tomographic colonography. Ann Intern Med. 2005;142:635-50. LinkGoogle Scholar6. Stryker SJ, Wolff BG, Culp CE, Libbe SD, Ilstrup DM, MacCarty RL. Natural history of untreated colonic polyps. Gastroenterology. 1987;93:1009-13. [PMID: 3653628] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Thomas F. Imperiale, MDAffiliations: From Indiana University Medical Center, Indianapolis, IN 46202-5102.Disclosures: Consultancies and grant support (Exact Sciences).Corresponding Author: Thomas F. Imperiale, MD, The Regenstrief Institute, Inc., 1050 Wishard Boulevard, Indianapolis, IN 46202-5102. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoMeta-Analysis: Computed Tomographic Colonography Brian P. Mulhall , Ganesh R. Veerappan , and Jeffrey L. Jackson Metrics Cited byNew Screening Guidelines for Colorectal Cancer: A Practical Guide for the Primary Care PhysicianBiomedical Imaging TechnologiesComputer-aided Detection of Colorectal Polyps: Can It Improve Sensitivity of Less-Experienced Readers? Preliminary FindingsMass Spectrometry-Based Study of the Plasma Proteome in a Mouse Intestinal Tumor ModelDouble-Contrast Barium Enema: Use in Practice and Implications for CT ColonographyEvolving and Experimental Technologies in Medical ImagingVirtual Colonoscopy: Current Status and Future Directions 19 April 2005Volume 142, Issue 8Page: 669-670KeywordsColonoscopyColorectal cancer screeningComputed axial tomographyForecastingLesionsRadiologistsSedationSpecificitySurgerySystematic reviews ePublished: 19 April 2005 Issue Published: 19 April 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...