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Bowel Cancer Screening Radiology 2011 Dr. FW Poon Investigation algorithm Colonoscopy Normal colonoscopy Complete colonoscopy but abnormal finding No further action Symptomatic route Incomplete examination Additional Imaging BE or CTC Date of Radiology offered within 3 weeks Radiology report on CRIS Report Screening IT system Print report to endoscopist Normal Patient/GP Abnormal Further appropriate assessment and Investigations by endoscopist Total number of colonoscopy For the calendar year 2009 - 1079 2010 - 2008 Most patients did not need additional radiology In 2010, 47 (2.3%) had additional radiology for failed colonoscopy Radiology 07/09-12/09 01/10-06/10 31 16 BE -1 polyp & -1 benign stricture 07/10-12/10 28 15 CTC -3 polyps Others : GS, AAA, Bladder cancer, mysenteric cyst 19 7 BE -1 ? Benign stricture 21 CTC 8 BE -1 polyp -4 cancers -3 polyps -1 ? benign Stricture Others: AAA, lipoma, 11 CTC -2 polyps Others: Renal stones, GS, HH,pneumonia In WOS, the overall trend is to perform more CTC instead of BE • What is CTC • What is BE • Why CTC better? Comparing BE vs CTC • 2-D imaging • Can only visualise mucosal abnormality • Overlapping structures make interpretation difficult • lower sensitivity and specificity than CTC What is CTC ? Polyp CT Colonoscopy BE vs CTC Perforation rate (diagnostic) Accuracy for large polyp (>10mm) Cancer Colonoscopy 2:1000 98% 97% DCBE 1:10,000 48% 83-94% CTC 5:10,000 59-85% 97% BMJ 2007; 335:715-8 CTC less discomfort compared BE and optical colonoscopy Bowel cancer screening • With the support of GGC Trust, an enormous effect has been made to make CTC more widely available • More fast CT scanners and more trained radiologists are now available to support the programme Bowel cancer screening The most important fact is to have your screening done
