Colorectal cancer and computed tomography colonography: a new screening option?

Assess the ability of computed tomography colonography (CTC) to perform at high levels of sensitivity and specificity for colorectal cancer screening in an asymptomatic population.

Systematic literature review.

Searches were done in PubMed, Cochrane Library, TRIP Database, and UptoDate, utilizing the terms CT colonography, colonoscopy, virtual colonoscopy, screening, and colon cancer. In PubMed the following limits and terms were used: published in the last 5 years, humans, meta-analysis, randomized controlled trial, and English.

A meta-analysis by Mulhall et al revealed two studies meeting inclusion/exclusion criteria: Pickhardt et al and Macari et al. Searching Pickhardt et al through "related articles" in PubMed yielded the Wessling et al study.

CTC can achieve high accuracy, but only under specific conditions using multi-detector CT scanners, primary 3D data interpretation, well-prepared patients, collimation of < or = 1.25 mm, and data interpretation by an experienced radiologist. Cost-effectiveness and compliance in the general population, as well as radiation exposure and follow-up requirements with colonography for CRC screening, need further study.