Primary CT colonography more sensitive than optical colonoscopy in detecting colorectal cancer
Tuesday, May 3, 2011 (Last Updated: 05/04/2011)
TUESDAY, May 3 (HealthDay News) -- Computed tomographic (CT) colonography is more sensitive than optical colonoscopy (OC) in detecting colorectal cancer, especially when both cathartic and tagging agents are combined in the bowel preparation, according to a meta-analysis published in the May issue of Radiology.
Perry J. Pickhardt, M.D., from the University of Wisconsin School of Medicine and Public Health in Madison, and colleagues assessed the sensitivity of CT colonography for detecting colorectal cancer in 49 studies from 1994 to 2009 that included 11,151 patients. The sensitivity of OC for detecting colorectal cancer was evaluated in a subset of 25 studies that included 9,223 patients, and which included a mechanism to determine true-positive versus false-negative OC diagnoses. Quality Assessment of Diagnostic Accuracy Studies guidelines and I² statistics were used to assess potential bias or heterogeneity.
The investigators found that the cumulative prevalence of colorectal cancer was 3.6 percent. CT colonography was 96.1 percent sensitive in detecting colorectal cancer with no heterogeneity (I² = 0 percent). When both cathartic and tagging agents were combined in the bowel preparation, no cancers were missed by CT colonography. OC was 94.7 percent sensitive for detecting colorectal cancer with a moderate degree of heterogeneity (I² = 50 percent).
"Our findings suggest that, assuming a reasonable level of specificity, primary CT colonography may be more suitable than OC for the initial investigation of suspected colorectal cancer," the authors write.
Two of the study authors disclosed financial relationships with the medical technology industry.
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