CT colonography: does it satisfy the necessary criteria for a colorectal screening test?

Abstract

Existing and emerging colorectal screening tests can be assessed in terms of the key categories of diagnostic performance, procedural risks, patient acceptability, and cost-effectiveness. To push a new screening test to acceptance, it need not outperform existing strategies in all of these criteria. Rather, a relative advantage in one criterion combined with acceptable performance in the others may be considered adequate. For computed tomographic colonography (CTC), a strong case can be made that this test meets or exceeds optical colonoscopy, the current screening standard, in all of these categories. Published data, including our own experience with CTC screening, will be reviewed to support this claim. Reasons why CTC has not yet achieved its full potential as a valuable screening test for colorectal cancer prevention will also be considered.

Keywords::

• colonoscopy
• colorectal cancer
• colorectal polyps
• CT colonography
• screening
• virtual colonoscopy

Financial & competing interests disclosure

PJ Pickhardt has served as a consultant for Midways, Braintree, Viatronix and Check-Cap; and is co-founder of VirtuoCTC. The author has no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.