CT Colonography Sensitive for Large Adenomas
Risk of adenomas five years later low in previously negative individuals
WEDNESDAY, Sept. 17 (HealthDay News) -- Computed tomographic (CT) colonography is a sensitive method for detecting large adenomas and cancers in asymptomatic adults, while individuals negative for adenomas are at low risk of developing cancers five years later, according to two studies published in the Sept. 18 issue of the New England Journal of Medicine.
In the first study, C. Daniel Johnson, M.D., from the Mayo Clinic Arizona in Scottsdale, and colleagues examined the accuracy of CT colonography in 2,531 asymptomatic patients aged 50 years or older. They found that the mean per-patient sensitivity of detection of large adenomas and cancers (at least 10 mm in diameter) was 0.90. This "indicates that CT colonography failed to detect a lesion measuring 10 mm or more in diameter in 10 percent of patients," the authors write.
In the second study, Thomas F. Imperiale, M.D., from Indiana University School of Medicine in Indianapolis, and colleagues examined the prevalence of adenomas and cancer in 1,256 individuals (mean age 56.7 years) who had been negative for adenomas at their previous screening about five years earlier. The investigators found no cancers on rescreening, although 16 percent of patients had adenomas. Advanced adenomas were found in 1.3 percent of all patients and were more common in men (relative risk 3.31), the report indicates.
"These two studies have strengthened the evidence base for practices already recommended by expert groups," Robert H. Fletcher, M.D., from Harvard Medical School in Boston, writes in an accompanying editorial. "Screening colonoscopy is recommended at 10-year intervals for people who have had normal colonoscopic examinations, and CT colonography is one of the recommended screening tests."
The authors of the first study disclosed financial relationships with various device companies.
Abstract - Johnson
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Abstract - Imperiale
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Editorial
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