Document Detail


An analysis of the potential impact of computed tomographic colonography (virtual colonoscopy) on colonoscopy demand.
MedLine Citation:
PMID:  15521000     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND AIMS: There has been much speculation about the potential impact on the use of conventional colonoscopy if "virtual" computed tomographic colonography (CTC) became a widely accepted modality for colorectal cancer (CRC) screening. However, no formal analysis of the impact of CTC on colonoscopy demand has been reported. METHODS: A mathematical model to predict colonoscopy demand based on several relevant input parameters was constructed. Current national colonoscopy practice, estimated using various published reports, was used as the foundation to project colonoscopy demand if CTC were implemented as the primary CRC screening modality. RESULTS: In the base-case analysis, if CTC were used as the primary modality for CRC screening, 1.78 million colonoscopies could be eliminated from the total 6.47 million in 2003. Depending on the polyp size threshold used to define a CTC study as positive (6 or 10 mm), this loss would be partially offset by 1.21 million (6 mm) or .34 million (10 mm) follow-up colonoscopies for CTC examinations with positive findings, resulting in a net loss of .57 million (8.8% decrease) (6 mm) or 1.44 million (22.3% decrease) (10 mm). Extensive sensitivity analyses showed that the findings of this model were robust and insensitive to most parameters tested but were sensitive to a few parameters, including the percentage of CTC examinations with positive findings. CONCLUSIONS: Wide-scale implementation of CTC for CRC screening would likely lead to a decrease in use of conventional colonoscopy. The percentage of CTC studies with positive findings seemed to be a pivotal variable, which would be determined in large part by the polyp size ultimately established to define a positive finding.
Authors:
Chin Hur; G Scott Gazelle; Michael E Zalis; Daniel K Podolsky
Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Gastroenterology     Volume:  127     ISSN:  0016-5085     ISO Abbreviation:  Gastroenterology     Publication Date:  2004 Nov 
Date Detail:
Created Date:  2004-11-02     Completed Date:  2004-12-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0374630     Medline TA:  Gastroenterology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1312-21     Citation Subset:  AIM; IM    
Affiliation:
Gastrointestinal Unit, Harvard Medicasl School, Boston, MA, USA. chur@mgh-ita.org
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MeSH Terms
Descriptor/Qualifier:
Colonography, Computed Tomographic / methods*,  mortality,  statistics & numerical data
Colonoscopy / methods*,  statistics & numerical data
Humans
Models, Theoretical
Patient Compliance
Reproducibility of Results
Sensitivity and Specificity
United States

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


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