Computed tomographic colonography in subjects with positive faecal occult blood test refusing optical colonoscopy

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• 作者：Lapo Sali^a ; ^{lapo.sali@unifi.it} ; Grazia Grazzini^b ; Leonardo Ventura^b ; Massimo Falchini^a ; Alessandra Borgheresi^a ; Guido Castiglione^b ; Michele Grimaldi^a ; Nicola Ianniciello^c ; Beatrice Mallardi^b ; Marco Zappa^b ; Mario Mascalchi^a
• 关键词：Colonoscopy ; Colorectal cancer screening ; CT colonography ; Faecal occult blood test
• 刊名：Digestive and Liver Disease
• 出版年：2013
• 出版时间：April, 2013
• 年：2013
• 卷：45
• 期：4
• 页码：285-289
• 全文大小：438 K

文摘

Background

Refusal of colonoscopy is a drawback of colorectal cancer screening programmes based on faecal occult blood test. Computed-tomographic-colonography is generally more accepted than colonoscopy.

Aim

To compare adherence to computed-tomographic-colonography and second-invitation colonoscopy in subjects with positive faecal test refusing colonoscopy.

Methods

We performed a prospective study in 198 subjects with positive faecal test who refused first referral to colonoscopy in one endoscopy service of the Florence screening programme. Subjects were randomly invited to computed-tomographic-colonography (n = 100) or re-invited to colonoscopy (n = 98). Mail invitation was followed by a questionnaire administered by phone. Computed-tomographic-colonography findings were verified with colonoscopy.

Results

32 subjects could not be reached, 71 (35.9 % ) had undergone colonoscopy on their own; 4 were excluded for contraindications; 30/48 (62.5 % ) in the computed-tomographic-colonography arm and 11/43 (25.6 % ) in the colonoscopy arm accepted the proposed examinations (p < 0.001). Four advanced adenomas and 1 cancer were found in the 28 subjects who ultimately underwent computed-tomographic-colonography and 2 advanced adenomas and 2 cancers in the 9 subjects who ultimately underwent second-invitation colonoscopy.

Conclusion

Subjects with positive faecal occult blood test refusing colonoscopy show a higher adherence to computed-tomographic-colonography than to second invitation colonoscopy.