Performance of computed tomography colonoscopy (CTC) in comparison to colonoscopy in the two-week wait lower gastrointestinal (GI) pathway

Faecal immunochemical testing reduces demand and improves yield of Leicester's 2‐week pathway for change in bowel habit

“…These findings are similar to the results of the second round of UK CRC screening pilot that showed the colonoscopy uptake rate at 82.8% [17]. Moreover, colonoscopies are more likely to be non-diagnostic at 10.7% whereas the CTC non-diagnostic level was found to be as low as 1.6% [15].…”

“…Our findings are comparable to other studies in the UK. NICE FIT reported 97.7% sensitivity for CRC at a cut‐off value of 2 μg/g, the lowest detectable rate on the HM‐JACKarc analytical system [15]. Similar outcomes were reported by Chapman et al [8] with a sensitivity of 97.2% using a cut‐off of 4.0 μg Hb/g faeces.…”

“…In assessing additional pertinent factors, the Leicester study reported higher completion rates 100% (vs. 86% for colonoscopies) and fewer cancellations (colonoscopy cancellation rate significantly higher at 6.5% vs. only 2% for CTCs) [15]. These findings are similar to the results of the second round of UK CRC screening pilot that showed the colonoscopy uptake rate at 82.8% [17].…”

“…In this study we looked at the impact of the FIT on service provision in the Leicester two-week pathway for CIBH, in terms of both CRC detection and whether it offered an opportunity to be cost effective at both 4 μg Hb/g faeces, that is, the limit of quantification using the OC-Sensor (Eiken Chemical Co.), as well as the recent NICE recommended cut-off of 10 μg Hb/g faeces. CTCs as an appropriate first-line test for CRC exclusion; CTC detection rates were comparable to colonoscopy for both CRCs (4.5% for colonoscopies and 4.9% for CTCs) and polyps larger than 5 mm (9.6% for colonoscopies and 13.5% for CTCs) while colonoscopies had higher detection rates of polyps of any size at 25% [15]. These findings were similar to the outcomes of the multicentre randomized trial SIGGAR for detection rates of large polyps and CRCs between CTC and colonoscopy [16].…”

“…The University Hospitals of Leicester NHS Trust (UHL) shifted towards CT colonography (CTC) due to increased pressures on endoscopy services. A retrospective analysis of the UHL 2WW lower gastrointestinal pathway by Stephenson et al (2018) determined CTCs as an appropriate first‐line test for CRC exclusion; CTC detection rates were comparable to colonoscopy for both CRCs (4.5% for colonoscopies and 4.9% for CTCs) and polyps larger than 5 mm (9.6% for colonoscopies and 13.5% for CTCs) while colonoscopies had higher detection rates of polyps of any size at 25% [15]. These findings were similar to the outcomes of the multicentre randomized trial SIGGAR for detection rates of large polyps and CRCs between CTC and colonoscopy [16].…”