Authors' objectives:

This review aims to assess the available evidence on computed tomography (CT) colonography.

Authors' recommendations: CT colonography has been assessed in a relatively large number of clinical studies, mainly addressing patients with disease symptoms or patients with a genetic predisposition to be at higher risk for colon disease. The extent to which CT colonography can complement or replace colonoscopy in diagnosing polyps and tumors depends on the detection level (polyp size) considered as clinically relevant. Most studies have shown that CT colonography offers high diagnostic reliability for malignant tumors and polyps 10 mm or larger, inconsistent diagnostic reliability for changes of 5 to 9 mm, and insufficient diagnostic reliability for changes smaller than 5 mm. Some studies, however, have shown unacceptable diagnostic reliability even for malignant tumors and polyps larger than 10 mm. The extent to which CT colonography can replace double-contrast barium enema in patients with disease symptoms has not been completely studied since CT colonography almost exclusively has been compared to colonoscopy. However, the diagnostic reliability of CT colonography compared to colonoscopy appears to be at least equal to the diagnostic reliability of double contrast barium enema compared to colonoscopy. In findings of colon tumors, CT colonography can, in the same examination, also provide information on changes in adjacent tissues and metastases in the lymph nodes and liver. Patients usually experience less discomfort and pain with CT colonography than with conventional colonoscopy and double-contrast barium enema. Generally, however, it is not the examination per se that causes the most discomfort for the patient, but the pre-examination procedure, ie, the use of laxatives, that is similar in all of the methods. Scientific evidence on the diagnostic reliability of CT colonography is not fully conclusive. The differences in results from different studies can be due to differences in equipment, procedures, and experience. Scientific evidence for assessing the cost effectiveness of the method is lacking. Studies should be conducted on expected effects and costs under ordinary conditions before applying the method more generally in routine health services.

Authors' methods: Review

Project Status: Completed

URL for project: http://www.sbu.se/Published

Year Published: 2004

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Sweden

Organisation Name: Swedish Agency for Health Technology Assessment and Assessment of Social Services

Contact Address: P.O. Box 3657, SE-103 59 Stockholm, Sweden. Tel: +46 8 4123200, Fax: +46 8 4113260

Contact Name: registrator@sbu.se

Contact Email: registrator@sbu.se

Copyright: Swedish Council on Technology Assessment in Health Care (SBU)