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Related Experiment Videos

Colon cancer detection: an algorithm using endoscopy and barium enema

D M Hough1, D E Malone, J Rawlinson

  • 1Department of Radiology, McMaster University Medical Centre, Hamilton, Ontario, Canada.

Clinical Radiology
|March 1, 1994
PubMed
Summary
This summary is machine-generated.

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Flexible sigmoidoscopy (FS) combined with modified double-contrast barium enema (MDCBE) shows promise for detecting colonic cancers and polyps. This algorithm could reduce the need for colonoscopies in patients with rectal bleeding.

Area of Science:

  • Gastroenterology
  • Diagnostic Imaging
  • Colorectal Cancer Screening

Background:

  • Rectal bleeding necessitates accurate diagnosis of colonic neoplasia.
  • Flexible sigmoidoscopy (FS) and colonoscopy are common diagnostic tools.
  • Double-contrast barium enema (DCBE) can visualize the colon.

Purpose of the Study:

  • To evaluate an algorithm using FS and modified DCBE (MDCBE) for detecting colonic cancers and polyps.
  • To assess the diagnostic performance of FS combined with MDCBE (FS+MDCBE).
  • To determine the potential reduction in colonoscopy referrals using this algorithm.

Main Methods:

  • A review of 66 patients with rectal bleeding was conducted.
  • An algorithm directed patients based on FS findings to either colonoscopy or MDCBE.

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  • FS+MDCBE was used to detect colonic cancers and polyps.

    • Main Results:

    • FS+MDCBE demonstrated 100% sensitivity for polyps > 5 mm and cancer.
    • The combined method had 82% specificity, a negative predictive value of 1.0, and a positive predictive value of 0.62.
    • Four small polyps (< 5 mm) were missed by FS+MDCBE.
    • The algorithm indicated that 36% of patients would require colonoscopy.

    Conclusions:

    • FS+MDCBE is a potentially valuable screening method for colonic neoplasia.
    • The proposed algorithm may help triage patients effectively, potentially reducing colonoscopy rates.
    • Further validation is warranted for this diagnostic approach in managing rectal bleeding.