Document Detail


A comparison of optical colonoscopy and CT colonography screening strategies in the detection and recovery of subcentimeter adenomas.
MedLine Citation:
PMID:  20842111     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Evidence has shown that computerized tomographic colonography (CTC) and optical colonoscopy (OC) can detect advanced adenomas at an equal rate; however, a comparison of the subcentimeter adenoma detection has not been performed. The objective of this study is to compare CTC and OC screening programs, with a focus on the detection and recovery of subcentimeter adenomas.
METHODS: In all, 1,700 screening OC examinations in average-risk patients were compared with 1,307 CTC examinations in similar patients drawn from the same referral pool completed in 2006-2008. The detection rate for adenomas ≤ 5 mm, 6-9 mm, and <10 mm with advanced histology were compared.
RESULTS: In the OC group, 23.2% of patients had at least one adenoma removed; in the CTC screening group, 5.9% of patients had at least one adenoma detected and removed, P<0.001. There were significantly more ≤ 5 mm adenomas (detection rate 0.22, 378/1,700) detected by OC than by CTC (detection rate 0.04, 56/1,307), P<0.001. There were significantly more adenomas 6-9 mm (detection rate 0.12, 204/1,700) detected by OC than by CTC (detection rate 0.05, 67/1,307), with 70 patients with polyps of unknown histology in CTC surveillance, P<0.001. The number of advanced lesions <10 mm detected by OC (15/1,700) compared with CTC (4/1,307) were not significantly different, P=0.06. In the OC group, 27.1% of patients had non-adenomatous polyps removed; in the CTC group, 4.1% of patients had non-adenomatous polyps removed, P<0.001.
CONCLUSIONS: (i) An OC screening program detects and recovers a significant four and a half fold greater number of non-advanced adenomas compared with a CTC screening program. (ii) The primary difference between screening with OC and CTC is the recovery and management of the subcentimeter adenoma.
Authors:
Mark Benson; Parul Dureja; Deepak Gopal; Mark Reichelderfer; Patrick R Pfau
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-09-14
Journal Detail:
Title:  The American journal of gastroenterology     Volume:  105     ISSN:  1572-0241     ISO Abbreviation:  Am. J. Gastroenterol.     Publication Date:  2010 Dec 
Date Detail:
Created Date:  2010-12-06     Completed Date:  2011-01-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0421030     Medline TA:  Am J Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2578-85     Citation Subset:  IM    
Affiliation:
Department of Medicine, Section of Gastroenterology and Hepatology, University of Wisconsin Medical School, Madison, Wisconsin 53792-5124, USA.
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MeSH Terms
Descriptor/Qualifier:
Adenoma / diagnosis*,  pathology,  radiography,  surgery
Cathartics / administration & dosage
Chi-Square Distribution
Colonic Polyps / diagnosis*,  pathology,  radiography,  surgery
Colonography, Computed Tomographic / methods*
Colonoscopy / methods*
Colorectal Neoplasms / diagnosis*,  pathology,  radiography,  surgery
Female
Humans
Male
Mass Screening
Middle Aged
Retrospective Studies
Chemical
Reg. No./Substance:
0/Cathartics
Comments/Corrections
Comment In:
Am J Gastroenterol. 2010 Dec;105(12):2586-7   [PMID:  21131927 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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