Diagnostic accuracy of computed tomographic colonography for the detection of advanced neoplasia in individuals at increased risk of colorectal cancer

Autor: Giovanni Simonetti, Didier Bielen, Giovanni Gandini, Silvia Venturini, G. Galatola, Patrizia Della Monica, Andrea Grasso, Giuseppe Angelelli, Claudia Borghi, Carlo Bartolozzi, Cesare Hassan, Maria Carla Cassinis, Luca Boni, Carlo Senore, Daniele Regge, Teresa Gallo, Maria Cristina Martina, Brunella Barbaro, Paolo Bruzzi, Luigina Bonelli, C. Laudi, Massimo Galia, Andrea Laghi, Emanuele Neri, R. Asnaghi
Přispěvatelé: Regge, D, Laudi, C, Galatola, G, Della Monica, P, Bonelli, L, Angelelli, G, Asnaghi, R, Barbaro, B, Bartolozzi, C, Bielen, D, Boni, L, Borghi, C, Bruzzi, P, Cassinis, MC, Galia, M, Gallo, TM, Grasso, A, Hassan, C, Laghi, A, Martina, MC, Neri, E, Senore, C, Simonetti, G, Venturini, S, Gandini, G
Rok vydání: 2009
Předmět:
Male
occult blood test
Colorectal cancer
Colonoscopy
cancer risk
prediction and forecasting
Gastroenterology
Risk Factors
cancer diagnosis
Positive predicative value
advanced cancer
Medicine
Family history
comparative study
colorectal adenoma
family history
education.field_of_study
medicine.diagnostic_test
article
clinical trial
General Medicine
Middle Aged
priority journal
risk factor
Predictive value of tests
diagnostic accuracy
Female
diagnostic value
Colorectal Neoplasms
Colonography
Computed Tomographic
radiography
Computed Tomographic
Adult
medicine.medical_specialty
Settore MED/12 - GASTROENTEROLOGIA
Population
colorectal cancer
Sensitivity and Specificity
Predictive Value of Tests
Internal medicine
adult
aged
cancer classification
colonoscopy
computed tomographic colonography
controlled clinical trial
controlled study
cross-sectional study
female
human
major clinical study
male
multicenter study
predictive validity
colorectal tumor
middle aged
sensitivity and specificity
Aged
Cross-Sectional Studies
Humans
education
business.industry
Fecal occult blood
Sigmoidoscopy
Colonography
medicine.disease
CT colonography
colorectal cancer
screening
Settore MED/36 - Diagnostica Per Immagini E Radioterapia
business
Zdroj: JAMA. 301(23)
ISSN: 1538-3598
Popis: CONTEXT: Computed tomographic (CT) colonography has been recognized as an alternative for colorectal cancer (CRC) screening in average-risk individuals, but less information is available on its performance in individuals at increased risk of CRC. OBJECTIVE: To assess the accuracy of CT colonography in detecting advanced colorectal neoplasia in asymptomatic individuals at increased risk of CRC using unblinded colonoscopy as the reference standard. DESIGN, SETTING, AND PARTICIPANTS: This was a multicenter, cross-sectional study. Individuals at increased risk of CRC due to either family history of advanced neoplasia in first-degree relatives, personal history of colorectal adenomas, or positive results from fecal occult blood tests (FOBTs) were recruited in 11 Italian centers and 1 Belgian center between December 2004 and May 2007. Each participant underwent CT colonography followed by colonoscopy on the same day. MAIN OUTCOME MEASURES: Sensitivity and specificity of CT colonography in detecting individuals with advanced neoplasia (ie, advanced adenoma or CRC) 6 mm or larger. RESULTS: Of 1103 participants, 937 were included in the final analysis: 373 cases in the family-history group, 343 in the group with personal history of adenomas, and 221 in the FOBT-positive group. Overall, CT colonography identified 151 of 177 participants with advanced neoplasia 6 mm or larger (sensitivity, 85.3%; 95% confidence interval [CI], 79.0%-90.0%) and correctly classified results as negative for 667 of 760 participants without such lesions (specificity, 87.8%; 95% CI, 85.2%-90.0%). The positive and negative predictive values were 61.9% (95% CI, 55.4%-68.0%) and 96.3% (95% CI, 94.6%-97.5%), respectively; after group stratification, a significantly lower negative predictive value was found for the FOBT-positive group (84.9%; 95% CI, 76.2%-91.3%; P < .001). CONCLUSIONS: In a group of persons at increased risk for CRC, CT colonography compared with colonoscopy resulted in a negative predictive value of 96.3% overall. When limited to FOBT-positive persons, the negative predictive value was 84.9%.
Databáze: OpenAIRE
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