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Virtual Colonography Inferior to Colonoscopy

In patients with positive fecal occult blood test, follow-up with computerized tomography colonography was less accurate and possibly pricier

THURSDAY, Dec. 13 (HealthDay News) -- In patients with a positive fecal occult blood test, computerized tomography colonography (CTC) is less accurate and effective, and potentially more expensive than standard colonoscopy in detecting colorectal neoplasia, according to a report published in the December issue of Clinical Gastroenterology and Hepatology.

Silke Walleser, of the University of Sydney in Australia, and colleagues conducted a systematic review of five studies that compared the ability of CTC and colonoscopy to detect cancers in non-screening populations and lesions 10 millimeters or greater, and performed a cost-effectiveness analysis.

The researchers found that CTC had a lower sensitivity (63 percent) and specificity (95 percent) than colonoscopy (95 and 99.8 percent, respectively) in detecting lesions 10 mm or greater, and for the detection of cancer (89 and 97 percent versus 96 and 99.7 percent, respectively).

"The results of the cost-effectiveness analysis suggest that CTC is less effective in terms of life-years saved and potentially more costly, depending on the prevalence of colorectal polyps and the follow-up costs for a positive CTC," the authors conclude. "There is future potential for this evolving technology with improvements in CTC technology and radiologist experience that may lead to improved performance."

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