Colonic polyps: inheritance, susceptibility, risk evaluation, and diagnostic management

Area of Science:

• Oncology
• Radiology
• Gastroenterology

Background:

• Colorectal cancer (CRC) is a leading cause of cancer incidence and mortality globally.
• Western diets (low-fiber, high-fat) and genetic predispositions are significant risk factors for CRC.
• The adenoma-carcinoma sequence highlights the genetic basis of CRC, informing screening strategies.

Purpose of the Study:

• To review and compare various colorectal cancer screening and diagnostic techniques.
• To highlight the evolution and clinical validation of computed tomography colonography (CTC) for CRC screening.
• To discuss the advantages of CTC over other methods like optical colonoscopy (OC) and double contrast barium enema (DCBE).

Main Methods:

• Review of existing literature on CRC screening modalities.
• Discussion of the strengths and weaknesses of rectosigmoidoscopy, OC, DCBE, and CTC.
• Focus on the technical aspects and diagnostic capabilities of CTC, including 2D/3D reconstructions and computer-aided detection (CAD).

Main Results:

• CTC has emerged as an accurate and mature diagnostic approach for CRC screening.
• CTC provides cross-sectional imaging of the entire colon, detects extracolonic findings, and is less invasive and costly than OC.
• Modern CT scanners and CAD systems enhance CTC's diagnostic accuracy, efficiency, and image quality with low radiation doses.

Conclusions:

• Computed tomography colonography (CTC) is a validated and widely accepted method for colorectal cancer screening.
• CTC offers a favorable balance of diagnostic accuracy, patient comfort, and cost-effectiveness compared to traditional methods.
• Advancements in CT technology and CAD systems further solidify CTC's role in improving CRC detection and patient outcomes.