Extracolonic Findings on CT Colonography Increase Yield of Colorectal Cancer Screening

Strategic Insights -

A study published in the Ajr American Journal of Roentgenology revealed that extracolonic findings on CT colonography can significantly increase the yield of colorectal cancer screening. The study involved a retrospective cohort of patients undergoing screening CT colonography at Walter Reed Army Medical Center between August 2003 and June 2006. The researchers found that extracolonic findings were identified in 46% of patients, with 34.5% of these findings being insignificant and 11% being significant. The evaluation of significant findings led to 280 radiology procedures and 19 surgeries, with a total cost of $113,179.

Key Takeaways:

  • The study involved a cohort of 2,277 patients undergoing screening CT colonography at Walter Reed Army Medical Center between August 2003 and June 2006.
  • Extracolonic findings were identified in 46% of patients, with 34.5% being insignificant and 11% being significant.
  • The evaluation of significant findings led to 280 radiology procedures and 19 surgeries, with a total cost of $113,179.
  • Seven high-risk lesions were identified in patients with significant extracolonic findings, including six extracolonic malignancies and one large aortic aneurysm.
  • CTC increased the odds of identifying high-risk lesions by 78% compared to identifying intracolonic lesions alone.
  • 11 out of 16 high-risk lesions identified underwent curative resection, with 5 of these being extracolonic.
  • The researchers concluded that CTC should be considered as an alternative to optical colonoscopy for colorectal cancer screening or as a one-time procedure to identify significant treatable intracolonic and extracolonic lesions.

Statistics:

  • 2,277 patients completed a screening CTC from August 2003 to June 2006 at Walter Reed Army Medical Center.
  • Extracolonic findings were identified in 1,037 (46%) patients.
  • 787 (34.5%) extracolonic findings were insignificant.
  • 240 (11.0%) extracolonic findings were significant.
  • 280 radiology procedures were performed as a result of significant findings.
  • 19 surgeries were performed as a result of significant findings.
  • The total cost of radiology studies was $113,179.
  • The studies added approximately $50 extra per patient.

Sources:

  • Veerappan, G.R., et al. "Extracolonic findings on CT colonography increases yield of colorectal cancer screening." Ajr American Journal of Roentgenology, 2010;195(3):677-86.