Computed tomographic colonography versus colonoscopy for investigation of patients with symptoms suggestive of colorectal cancer (SIGGAR): a multicentre randomised trial

Atkin, Wendy; Dadswell, Edward; Wooldrage, Kate; Kralj-Hans, Ines; Wagner, Christian von; Edwards, Rob; Yao, Guiqing; Kay, Clive; Burling, David; Faiz, Omar; Teare, Julian; Lilford, Richard; Morton, Dion; Wardle, Jane; Halligan, Steve

doi:10.1016/s0140-6736(12)62186-2

Cited by 220 publications

(189 citation statements)

References 32 publications

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“…To date, these have mainly been conducted in the setting of secondary care: one example is provided by the SIGGAR trial, which was designed to compare the effectiveness of CT colonography versus that of colonoscopy in individuals with symptoms suggestive of colorectal cancer. 2 An alternative approach is to perform trials of cancer diagnostics in a community care setting, and a number of trials using this approach now have results available, or are in progress. These cover a variety of interventions:…”

Section: [H1] Benefits Of Expedited Symptomatic Diagnosis [H2] Types mentioning

confidence: 99%

Improving early diagnosis of symptomatic cancer

Hamilton

Walter

Rubin³

et al. 2016

Nat Rev Clin Oncol

108

125

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| Much time, effort and investment goes into the diagnosis of symptomatic cancer, with the expectation that this approach brings clinical benefits. This investment of resources has been particularly noticeable in the UK, which has, for several years, appeared near the bottom of international league tables for cancer survival in economically developed countries. This Review examines expedited diagnosis of cancer from four perspectives. The first examines the potential for benefits from expedited diagnosis of symptomatic cancer. Limited evidence from clinical trials is available, but the considerable observational evidence suggests benefits can be obtained from this approach. The second perspective considers how expedited diagnosis can be achieved. We concentrate on data from the UK, where extensive awareness campaigns have been conducted, and initiatives in primary care, including clinical decision support, have all occurred during a period of considerable national policy change. The third section considers the most appropriate patients for cancer investigations, and the possible community settings for this. UK national guidance for selection of patients for investigation is discussed. Finally, the health economics of the subject are reviewed, although few studies provide definitive evidence on this topic.In all developed countries, much time, effort and finance is spent on the diagnosis of cancer.

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Section: [H1] Benefits Of Expedited Symptomatic Diagnosis [H2] Types mentioning

confidence: 99%

Improving early diagnosis of symptomatic cancer

Hamilton

Walter

Rubin³

et al. 2016

Nat Rev Clin Oncol

108

125

View full text Add to dashboard Cite

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“…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).…”

Section: Abstract Computed Tomography Colonography · Virtual Colonoscmentioning

confidence: 99%

“…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].…”

Section: Abstract European Society Of Gastrointestinal Endoscopy (Esgmentioning

confidence: 99%

“…Nonetheless, the ability to detect and remove early colonic lesions, the possibility to perform histologic analysis of diagnosed CRC and the higher sensitivity for the detection of colitis and anal pathology remain potential advantages of CS over CTC. On the other side, diverticulosis, one of the major causes of nonspecific abdominal symptoms in the elderly is better diagnosed with CTC [2]. Further research is needed in this area to better stratify the patients to refer those with higher probability to find a lesion to CS and the others to CTC.…”

Section: Abstract European Society Of Gastrointestinal Endoscopy (Esgmentioning

confidence: 99%

See 1 more Smart Citation

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

2015

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“…Different radiologists use different convention to assess the polyp (Atkin et al, 2013). The accuracy and sizes of measurement is highly variable among multisite studies and hence a standard protocol realization is required to conclude the sensitivity and specificity (Summers, 2010;Broadstack, 2007).…”

Section: Comparison Between Ctc and Colonoscopymentioning

confidence: 99%