Trends in use of barium enema examination, colonoscopy, and sigmoidoscopy: is use commensurate with risk of disease?

Karasick, Stephen; Ehrlich, Saundra M.; Levin, DA; Harford, R J; Rosetti, E F; Ricci, Judith A.; Beam, L M; Gigliotti, Jordan

doi:10.1148/radiology.195.3.7754010

Cited by 31 publications

(14 citation statements)

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“…La colonoscopia es una técnica que ha demostrado su eficacia diagnóstica y terapéutica en múlti-ples patologías gastrointestinales, aunque de forma muy especial en el cáncer colorectal (CCR) [2][3][4] . Por otra parte, su utilización, en los últimos años, como método de cribado del CCR 5 y el uso de la colonoscopia en pacientes con sintomatología de colon irritable sin síntomas de riesgo pero con la necesidad de descartar organicidad 6 , aumenta todavía más la demanda de este procedimiento.…”

Section: Introductionunclassified

Adecuación de la indicación de la colonoscopia según los nuevos criterios de EPAGE II

Carrión

Marín

Lorenzo-Zúñiga

et al. 2010

Gastroenterología y Hepatología

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Section: Introductionunclassified

Adecuación de la indicación de la colonoscopia según los nuevos criterios de EPAGE II

Carrión

Marín

Lorenzo-Zúñiga

et al. 2010

Gastroenterología y Hepatología

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“…Colonoscopy is a widely available diagnostic modality that has replaced barium enema for colorectal examination [1] . The growing demand of gastrointestinal (GI) endoscopy in most developed countries has determined an unavoidable increase of health care costs, therefore health care systems are experiencing a cost crisis [2,3] .…”

Section: Introductionmentioning

confidence: 99%

Appropriateness of colonoscopy: Diagnostic yield and safety in guidelines

Grassini

Verna²,

Niola³

et al. 2007

WJG

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AIM:To evaluate if the guidelines for the appropriateness of performing colonoscopy by American Society for Gastrointestinal Endoscopy (AGSE) and Italian Society of Digestive Endoscopy (SIED) yield a good diagnostic efficacy and do not present risks of missing important colonic pathologies in an Italian population sample. METHODS:A total of 1017 consecutive patients (560 men and 457 women; mean age 64.4 ± 16 years) referred to an open-access endoscopy unit for colonoscopy from July 2004 to May 2006 were evaluated according to ASGE and SIED guidelines for appropriateness of performing the procedure. Diagnostic yield was defined as the percentage of relevant colonic pathologies of the total number of colonoscopies performed.RESULTS: About 85.2% patients underwent colonoscopy that was considered appropriate based on at least one ASGE or SIED criterion, while it was considered inappropriate for 14.8% of patients. The diagnostic yield of colonoscopy was significantly higher for appropriate colonoscopies (26.94% vs 10.6%, P < 0.001) than for inappropriate colonoscopies (5.3%). There was no missed colorectal cancer following the ASGE/SIED criteria.CONCLUSION: ASGE/SIED guidelines have shown a good diagnostic yield and the rate of missing relevant colonic pathologies seems very low. Unfortunately, the percentage of inappropriate referrals for colonoscopy in an open-access endoscopy system is still high, despite the number of papers published on the issue and the definition of international guidelines. Further steps are required to update and standardize the guidelines to increase their diffusion and to promote educational programs for general practitioners.

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“…The overall volume of barium enemas performed in different parts of the United States decreased by 24% during a 12-year period from 1975 to 1986 (58) and by a staggering 45% during an 8-year period from 1985 to 1992 (59 in colorectal cancer screening because of its extremely low sensitivity in the detection of colonic neoplasms. On further analysis, however, this oftencited study consisted of a total of only 23 patients with polyps larger than 1 cm in diameter (65).…”

Section: Beginning Of the Endmentioning

confidence: 99%

History, Evolution, and Current Status of Radiologic Imaging Tests for Colorectal Cancer Screening

Levine¹,

Yee²

2014

Radiology

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Colorectal cancer screening is thought to be an effective tool with which to reduce the mortality from colorectal cancer through early detection and removal of colonic adenomas and early colon cancers. In this article, we review the history, evolution, and current status of imaging tests of the colon-including single-contrast barium enema, double-contrast barium enema, computed tomographic (CT) colonography, and magnetic resonance (MR) colonography-for colorectal cancer screening. Despite its documented value in the detection of colonic polyps, the double-contrast barium enema has largely disappeared as a screening test because it is widely perceived as a labor-intensive, time-consuming, and technically demanding procedure. In the past decade, the barium enema has been supplanted by CT colonography as the major imaging test in colorectal cancer screening in the United States, with MR colonography emerging as another viable option in Europe. Although MR colonography does not require ionizing radiation, the radiation dose for CT colonography has decreased substantially, and regular screening with this technique has a high benefit-to-risk ratio. In recent years, CT colonography has been validated as an effective tool for use in colorectal cancer screening that is increasingly being disseminated.

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Trends in use of barium enema examination, colonoscopy, and sigmoidoscopy: is use commensurate with risk of disease?

Abstract: Colonoscopy has been replacing barium enema examination as the initial colorectal examination since 1985. Increased use of colonoscopy in patients with lower risk of neoplasia suggests that indications have become overly broad.

Cited by 31 publications

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Adecuación de la indicación de la colonoscopia según los nuevos criterios de EPAGE II

Adecuación de la indicación de la colonoscopia según los nuevos criterios de EPAGE II

Appropriateness of colonoscopy: Diagnostic yield and safety in guidelines

History, Evolution, and Current Status of Radiologic Imaging Tests for Colorectal Cancer Screening

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