A comparative analysis of colonoscopy, CT colonography and double contrast barium enema used in the detection of colorectal cancer.

Henry, Michelle (2009) A comparative analysis of colonoscopy, CT colonography and double contrast barium enema used in the detection of colorectal cancer. BSc dissertation, University of Portsmouth.

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    Abstract

    Aim: In the UK approximately 100 cases of colorectal cancer (CRC) are diagnosed everyday. Early detection dramatically improves the survival rate. The most effective diagnostic investigation for screening is controversial. This review aims to evaluate the performance of colonoscopy in the detection of CRC by comparing this procedure's sensitivity and specificity to that of computed tomography colonography (CT Colonography) and double contrast barium enema (DCBE). Method: A search of literature was undertaken to locate and select relevant data relating to sensitivity and specificity, reasons for missed lesions and interpretation errors for all three investigations. A total of 22 articles were reviewed, consisting of nine prospective, eight retrospective and five literature reviews. Results: Colonoscopy proved to have superior sensitivity and specificity for smaller lesions (less than 5 mm and 6-9 mm in size). As the size of lesion increased, sensitivity and specificity for all three modalities became more homogeneous but colonoscopy still showed superior performance. Conclusion: To avoid research bias continuing research into all three modalities should be considered, however, based on this literature review colonoscopy should be the investigation of choice for the detection of colorectal carcinoma in both asymptomatic and symptomatic patients because of its high sensitivity and specificity. It also has a potential role in screening but requires careful planning to ensure appropriate service capacity and cost effectiveness. CT colonography may come into the fore in the future as technology advances to include faecal tagging and computer aided interpretation but this is a way off for general use. CT colonography and DCBE also have the disadvantage imparting an ionising radiation dose.

    Item Type: Dissertation
    Departments/Research Groups: Faculty of Science > School of Health Sciences and Social Work
    Depositing User: Jane Polwin
    Date Deposited: 20 Jan 2011 12:48
    Last Modified: 28 Jan 2015 11:14
    URI: http://eprints.port.ac.uk/id/eprint/650

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