CT Colonography: Accuracy, Acceptance, and Safety

Conclusions

CTC has a comparable sensitivity for CRC to colonoscopy and also a comparable or slightly lower sensitivity for advanced neoplasia. As other screening programmes that employ tests that are much less accurate in the detection of adenomas and cancers have shown reductions in CRC-related mortality, it is reasonable to assume that the use of CTC in screening will lead to an even larger reduction in CRC-related mortality, provided that a substantial proportion of individuals participate. Overall, screenees prefer CTC over colonoscopy screening with a higher participation rate than for colonoscopy screening. Although radiation exposure is a potential drawback, this disadvantage is overemphasised, especially with newer technology. At this time-point, it is not entirely clear whether the detection of extracolonic findings at CTC is of net benefit and is cost effective, but with responsible handling, this may be the case. Future efforts will seek to further improve the technique, refine appropriate diagnostic algorithms and study cost-effectiveness.