Computed tomographic colonography versus barium enema for diagnosis of colorectal cancer or large polyps in symptomatic patients (SIGGAR): a multicentre randomised trial

Role of CT colonography for primary colorectal cancer screening

“…8 The accuracy of CTC in experienced centres is comparable to colonoscopy in average risk populations >65 years 9,10 and meta-analysis data comparing the >50 year population. The largest randomised multi-centre study of CTC performance (SIGGAR trial) recruited more than 4500 patients and found CTC was as accurate as colonoscopy for detection of large polyps and cancer, with superior examination completion rates.…”

Review: capsule colonoscopy—a concise clinical overview of current status

“…CTC has been proven to be more effective than barium enema (43,44) and as effective as conventional colonoscopy in the detection of colonic masses and large (i.e., ≥1 cm) polyps (45)(46)(47). Therefore, the US Preventive Services Task Force recently included CTC as a viable screening strategy for average risk asymptomatic 50-75 years subjects (48).…”

Editorial on the European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) guideline on clinical indications for CT colonography in the colorectal cancer diagnosis

“…The twentieth anniversary of CT colonography (CTC) sets another milestone in the history of this technique, following the publications of the first two randomized clinical trials on asymptomatic subjects [1] and symptomatic patients [2,3], respectively, and the updated edition of guidelines on CTC examination protocols [4]. In fact, the first guideline on indications for CTC was recently and simultaneously published on European Radiology [5], the official journal of the European Society of Radiology (ESR) and its sub-specialty societies, in this case the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), and on Endoscopy [6], the official journal of the European Society of Gastrointestinal Endoscopy (ESGE).…”

“…Thanks to the recent publication of the data of SIGGAR trial [2,3], a randomized clinical trial comparing CTC diagnostic accuracy for CRC or significant (≥1 cm) polyps with either CS or BE in two different arms, ESGE/ESGAR recommends CTC as an acceptable and equally sensitive alternative for patients with symptoms suggestive of CRC, when CS is contraindicated or not possible. This opens the doors of CTC to symptomatic patients, considering the extremely low positive predictive value of alarm symptoms [15].…”