CTC has supplanted barium enema as the preferred whole-colon examination in gFOBT-positive patients who cannot undergo colonoscopy or whose colonoscopy is incomplete, as a consequence of results from a randomised-controlled trial of 5,427 symptomatic patients that found CTC significantly more sensitive than barium enema, with a lesser false-negative rate.
Studies that included predominantly high risk subjects (symptomatic, history of hereditary CRC, personal history of polyps, CRC or IBD) were excluded, as well as studies that performed CT-colonography as a consequence of incomplete colonoscopy or studies that only performed colonoscopy after positive findings on CT-colonography.
Reference standard=colonoscopy after segmental unblinding or second look colonoscopy Reference standard=colonoscopy followed by a second look colonoscopy if there was no match for polyps >9 mm on CT-colonography Of the 2,600 subjects recruited, 69 subjects were excluded in the analysis as a consequence of incomplete colonoscopy and/or CT-colonography results, not further specified.
As a consequence of the numbers of colonoscopies, more individuals would suffer adverse events with screening based on FIT, than with screening based on gFOBT or FSIG.
Fourth, as a consequence of the study design (post-hoc analysis), the distal small hyperplastic polyps were not removed during colonoscopy.
Results from colonoscopy screening studies, suggest that FS, with the same threshold for colonoscopy as in the present study, allows detection of 70 80% of all patients with advanced neoplasia [ 23, 24].
Nevertheless, the feasibility of opting for colonoscopy as screening tool for average-risk groups may be questionable due to the shortage of medical endoscopic manpower and the risk of perforation associated with colonoscopy.
Quality standards for colonoscopy such as a standardized bowel cleansing, adenoma detection and cecal intubation rates have been established for screening colonoscopies of asymptomatic adults in the narrower sense.
As a consequence, many died of cold.
For CRC specifically, providers prefer colonoscopy as a screening tool because it allows for visualization of the entire bowel and easy removal of suspicious lesions as well as significant precancerous lesions.
