CT Colonography Shown Effective for Detecting Polyps and Cancer In Patients 65 Years of Age or Older
Leesburg, VA, May 14, 2018—CT colonography (CTC) is a highly effective, efficient, and convenient colorectal test in senior-age adults, with or without symptoms of colorectal cancer (CRC), according to an ahead-of-print article scheduled to be published in the July 2018 issue of the American Journal of Roentgenology (AJR).
The study authors, led by Perry J. Pickhardt, of the University of Wisconsin, conducted a systematic review of CTC studies published between January 1994 and August 2017 containing data on senior-age adults. The primary endpoint was the CTC-positive rate for large colorectal polyps (≥ 10 mm) and masses. Secondary endpoints included lesions ≥ 6 mm, proven advanced neoplasia, and CRC. A total of 34 studies with 41,680 subjects, including 18,798 of senior age, were included.
Pooled CTC-positive rates among senior-age patients using the 10-mm size threshold were found to be significantly lower in cohorts of patients with no symptoms compared with cohorts of patients with positive fecal occult blood tests and other symptoms of CRC. However, a uniformly high positive predictive value for advanced neoplasia at colonoscopy was seen for all senior-age cohorts using a 10-mm threshold where such data were available. CTC sensitivity for CRC was 93.0% in senior-age patients compared with 92.0% in younger patients. Overall, CTC detection rates were higher in senior-age adults compared with younger adults.
“This meta-analysis has shown that CTC is an effective test for senior-age patients with and without symptoms of CRC,” the study reported. “For screening of Medicare-age adults, one in every 12 screened would be referred to colonoscopy using the 10-mm threshold, on average, with a high yield for advanced neoplasia and high sensitivity for cancer detection. Compared with stool-based tests, the yield for advanced neoplasia is much higher, although colonoscopy utilization may be similar or less frequent.”
Founded in 1900, ARRS is the first and oldest radiology society in the United States, and is an international forum for progress in radiology. The Society's mission is to improve health through a community committed to advancing knowledge and skills in radiology. ARRS achieves its mission through an annual scientific and educational meeting, publication of the American Journal of Roentgenology (AJR) and InPractice magazine, topical symposia and webinars, and print and online educational materials. ARRS is located in Leesburg, VA.