Utilization of Computed Tomography Colonography (CTC) at a District General Hospital: A Retrospective Analysis

Colorectal cancer (CRC) is one of the most common cancers worldwide, necessitating efficient diagnostic pathways. While colonoscopy remains the gold standard, computed tomography colonography (CTC) offers a non-invasive alternative, particularly for elderly and comorbid patients. This retrospective study, conducted at a UK district general hospital (DGH), evaluated patterns of CTC utilization among patients referred for colonic investigations over a 12-month period. Despite CTC's high diagnostic accuracy (93% sensitivity for polyps > 10 mm) and its suitability for high-risk populations, it was used as a first-line investigation in only 3.5% of cases, markedly lower than the 12%-15% reported in tertiary centers. Contributing factors included limited radiologist training, restricted CT scanner capacity, and a prevailing institutional preference for colonoscopy. Addressing these DGH-specific barriers, such as resource constraints and workforce limitations, is critical to enhancing CTC's role within the two-week-wait (2WW) pathway. This study underscores the need for multicenter research to validate these findings and guide policy development, ensuring equitable access to non-invasive diagnostics for frail, comorbid, or preference-driven populations.