Authors' objectives:

This review aims to compare the effectiveness and safety of computed tomographic colonography (CTC) as a screening method for the detection of colon cancer and precancerous polyps with the reference standard of conventional colonoscopy

Authors' recommendations: With the limited sensitivity and specificity of CTC relative to colonoscopy, together with the lack of therapeutic intervention, this method of screening may result in inconvenience, cost, and complications of both tests. Based on the current evidence, CTC cannot be proposed for population-based colorectal cancer screening. Patients with colonic symptoms or a personal/family history of polyps will benefit more in several ways if they undergo colonoscopy including excision of premalignant polyps. Considering the possibility of assessing the entire colon, extracolonic structures, and tumour staging, CTC can be the examination of choice for preoperative evaluation of patients with colorectal carcinomas. CTC can be considered for diagnostic purposes in patients in whom performing colonoscopy is clinically contraindicated or for those patients who had incomplete colonoscopy because of stenosis or obstruction of the colon. Exposure to ionizing radiation is a potential disadvantage of CTC. Radiation dose associated with CTC is higher with the use of multi-slice scanner and increases with dual positioning. Radiation exposure is higher for female than the male. Magnetic resonance imaging-based virtual colonoscopy that excludes the risk of ionizing radiation could become more attractive than CTC in the future.

Authors' methods: Systematic review

Project Status: Completed

Year Published: 2003

URL for published report: http://www.health.gov.on.ca/english/providers/program/mas/tech/reviews/pdf/rev_tomocolon_100103.pdf

URL for additional information: http://www.hqontario.ca/evidence/publications-and-ohtac-recommendations/ohtas-reports-and-ohtac-recommendations/computed-tomographic-colonography

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Canada

Organisation Name: Medical Advisory Secretariat

Contact Address: Medical Advisory Secretariat, 20 Dundas Street West, 10th Floor, Toronto, ON M5G 2N6 CANADA. Tel: 416-314-1092l; Fax: 416-325-2364;

Contact Name: MASinfo.moh@ontario.ca

Contact Email: MASinfo.moh@ontario.ca

Copyright: Medical Advisory Secretariat, Ontario Ministry of Health and Long-Term Care