Extracolonic findings of computed tomographic colonography in Koreans

Park, Dong Il; Lee, Sun Young; Lee, Sung Kil; Kim, Young Ho; Lee, Soon Jin; Byeon, Jeong Sik; Huh, Kyu Chan; Shim, Ki Nam

doi:10.3748/wjg.15.1487

Cited by 13 publications

(7 citation statements)

References 14 publications

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“…In approximately 5%–10% of examinations, additional work-up may be necessary although there is some variation in reporting, most likely related to differences in the definition of important findings 63 64. The incidence of extracolonic findings of moderate or high importance at CTC is commonly reported to be approximately 10%–15% of screenees 61 65–67.…”

Section: Extracolonic Findingsmentioning

confidence: 99%

CT colonography: accuracy, acceptance, safety and position in organised population screening

Haan

Pickhardt

Stoker

2014

Gut

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Colorectal cancer (CRC) is the second most common cancer and second most common cause of cancer-related deaths in Europe. The introduction of CRC screening programmes using stool tests and flexible sigmoidoscopy, have been shown to reduce CRC-related mortality substantially. In several European countries, population-based CRC screening programmes are ongoing or being rolled out. Stool tests like faecal occult blood testing are non-invasive and simple to perform, but are primarily designed to detect early invasive cancer. More invasive tests like colonoscopy and CT colonography (CTC) aim at accurately detecting both CRC and cancer precursors, thus providing for cancer prevention. This review focuses on the accuracy, acceptance and safety of CTC as a CRC screening technique and on the current position of CTC in organised population screening. Based on the detection characteristics and acceptability of CTC screening, it might be a viable screening test. The potential disadvantage of radiation exposure is probably overemphasised, especially with newer technology. At this time-point, it is not entirely clear whether the detection of extracolonic findings at CTC is of net benefit and is cost effective, but with responsible handling, this may be the case. Future efforts will seek to further improve the technique, refine appropriate diagnostic algorithms and study cost-effectiveness.

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Section: Extracolonic Findingsmentioning

confidence: 99%

CT colonography: accuracy, acceptance, safety and position in organised population screening

Haan

Pickhardt

Stoker

2014

Gut

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“…Many of these areas of perceived deficiency at CTC are nuanced. For example, extra-colonic findings have been shown to hold both benefits and drawbacks, ultimately requiring 6–8% additional workup for findings outside of the colon, yet leading to the unsuspected identification of extra-colonic cancers in 0.3–0.6% and abdominal aortic aneurysms in 0.1–0.8% [28–35]. …”

Section: Discussionmentioning

confidence: 99%

Predictors of primary care provider adoption of CT colonography for colorectal cancer screening

et al. 2016

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Purpose To examine factors influencing primary care provider (PCP) adoption of CT colonography (CTC) for colorectal cancer (CRC) screening. Materials and Methods We performed a retrospective cohort study linking electronic health record (EHR) data with PCP survey data. Patients were eligible for inclusion if they were not up-to-date with CRC screening and if they had CTC insurance coverage in the year prior to survey administration. PCPs were included if they had at least one eligible patient in their panel and completed the survey (final sample N=95 PCPs; N=6,245 patients). Survey data included perceptions of CRC screening by any method, as well as CTC specifically. Multivariate logistic regression estimated odds ratios and 95% confidence intervals for PCP and clinic predictors of CRC screening by any method and screening with CTC. Results Substantial variation in CTC use was seen among PCPs and clinics (range 0–16% of CRC screening). Predictors of higher CTC use were PCP perceptions that CTC is effective in reducing CRC mortality, higher number of perceived advantages to screening with CTC, and Internal Medicine specialty. Factors not associated with CTC use were PCP perceptions of less organizational capacity to meet demand for colonoscopy, number of perceived disadvantages to screening with CTC, PCP age and gender, and clinic factors. Conclusion Significant variation in PCP adoption of CTC exists. PCP perceptions of CTC and specialty practice were related to CTC adoption. Strategies to increase PCP adoption of CTC for CRC screening should include emphasis on the effectiveness and advantages of CTC.

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“…Extracolonic findings are common at screening CTC and have been reported to occur in from one quarter to more than one half of screenees [ 92 – 97 ]. The incidence of extracolonic findings increases significantly with age; one study reported extracolonic findings in 55.4% of screenees younger than 65years and in 74% of those 65 years or older [ 96 ].…”

Section: Ct Colonography and Screening For Colorectal Cancermentioning

confidence: 99%

“…Work-up for (potentially) important extracolonic findings occurs in approximately 10% of cases [ 97 – 99 ]. The prevalence of extracolonic findings of moderate or high importance at CTC is commonly reported to be approximately 10%–15% of screenees [ 94 , 95 , 98 , 99 ], although higher prevalence is occasionally reported [ 92 , 100 ]. This difference is partly caused by variation in the definition of moderate and high importance findings.…”

Section: Ct Colonography and Screening For Colorectal Cancermentioning

confidence: 99%

Clinical indications for computed tomographic colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline

et al. 2014

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Colorectal cancer (CRC) is a major cause of morbidity and mortality [1, 2]. CRC screening by fecal occult blood testing (FOBT) has been shown to reduce CRC mortality [3, 4], and is currently used in several European countries. Colonoscopy is highly effective for detecting advanced neoplasia, and endoscopic polypectomy reduces subsequent CRC-specific incidence and mortality [5]. In Europe, colonoscopy is mainly used to investigate FOBT-positive or symptomatic patients, or as a preventive strategy in those with increased CRC risk [6].\ud \ud Computed tomographic colonography (CTC) is a minimally invasive imaging technique that is highly accurate for detecting colorectal cancer (CRC) and adenomatous polyps. The technique is standardized [7], and CTC is more easily performed than barium enema. Evidence-based data suggest that CTC is the natural replacement for barium enema and a complementary rather than an alternative examination to colonoscopy. However, the clinical scenarios for which CTC is indicated remain unclear. To address this uncertainty – 20 years after the first presentation of CTC at a radiological meeting [8] – the European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) decided to produce a common guideline regarding indications for CTC in clinical practice. Technical and quality issues of CTC have been deliberately excluded from this work as these have already been discussed separately [7]

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Extracolonic findings of computed tomographic colonography in Koreans

Cited by 13 publications

References 14 publications

CT colonography: accuracy, acceptance, safety and position in organised population screening

CT colonography: accuracy, acceptance, safety and position in organised population screening

Predictors of primary care provider adoption of CT colonography for colorectal cancer screening

Clinical indications for computed tomographic colonography: European Society of Gastrointestinal Endoscopy (ESGE) and European Society of Gastrointestinal and Abdominal Radiology (ESGAR) Guideline

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