NEW YORK (Reuters Health), Feb 18 - CT colonography (CTC), also known as virtual colonoscopy, performs as well as traditional optical colonoscopy in detecting advanced adenomas in an average-risk population, results of a study conducted in Germany indicate.
Dr. Anno Graser from University of Munich and colleagues compared the performance of the three most commonly used colorectal cancer screening tests -- optical colonoscopy, flexible sigmoidoscopy, and fecal occult blood testing (FOBT) -- with that of high-resolution, low-dose 64-multidetector-row CTC and fecal immunochemical stool testing (FIT).
It's the first time, the researchers say, that the five different screening tests were compared in parallel in the same patients.
The investigators report in the February issue of Gut that 307 patients completed CTC and optical colonoscopy while 269 patients provided stool samples for both FOBT and FIT. "Flexible sigmoidoscopy results were deduced from optical colonoscopy; no separate endoscopy was performed."
A total of 221 adenomas were detected. The sensitivities of optical colonoscopy, CTC and sigmoidoscopy for advanced colonic neoplasia were 100%, 96.7%, and 83.3%, respectively, compared with 32% and 20% for FIT and FOBT, respectively.
In comments to Reuters Health, Dr. Graser said: "Generally, based on our results one can now assume that CT colonography is a safe option for colorectal cancer screening, namely detection of clinically relevant polyps. We strongly advocate the recommendations of the American Cancer Society; they now recommend CTC every five years for colon cancer screening next to colonoscopy and FOBT."
On the other hand, Dr. Graser noted, "Stool tests show much inferior results in the detection of adenomas, which is in itself not surprising, yet they are still recommended for screening in many countries."
Furthermore, "Flexible sigmoidoscopy should really only be performed if colonoscopy is not wanted by the patient as polyps in the right colon are as frequent as in the left, and tend to be equally premalignant," Dr. Graser advised.
Gut 2009;58:241-248.
Last Updated: 2009-02-16 7:35:16 -0400 (Reuters Health)
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American Cancer Society recognizes virtual colonoscopy screening benefit, March 5, 2008
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