Authors' objectives: The diagnostic accuracy of virtual colonoscopy (VC) compared to optical colonoscopy (OC) remains questionable for two main reasons. Firstly, conflicting results have repeatedly been reported in original and large studies. Secondly, meta-analyses (MA) published at the time of our assessment could not be used for health technology assessment (HTA) as they included studies in which the mode of use of VC did not correspond to international current standards. Considering these facts, the French National Authority for Health (HAS) performed a new MA of the diagnostic accuracy of VC in the detection of polyps and colorectal cancer in order to advise National Health Insurance Funds making a decision on VC reimbursement.

Authors' recommendations: 24 studies involving 7202 patients were included. MA showed highly heterogeneous results, requiring the use of a mixed model (Markov chain Monte Carlo method). Whatever the lesion size, OC had significantly higher sensitivity and specificity than VC. Complications were infrequent for both. Subgroup analyses helped to define optimal technical characteristics of VC: complete colonic cleansing with faecal tagging, high spatial resolution imaging and expert reading combining 2D and 3D methods. HAS guidance concluded that VC cannot replace OC, except in the case of incomplete optical colonoscopy, serious comorbidities or patient refusal

Project Status: Completed

Year Published: 2010

URL for published report: http://www.has-sante.fr/portail/upload/docs/application/pdf/2010-02/rapport_coloscopie_virtuelle.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: France

Organisation Name: Haute Autorité de Santé

Contact Address: 2 avenue du Stade de France, 93218 Saint-Denis La Plaine Cedex, France. Tel: +33 01 55 93 71 88; Fax: +33 01 55 93 74 35;

Contact Name: has.seap.secretariat@has-sante.fr

Contact Email: has.seap.secretariat@has-sante.fr