Transcript Bowel Cancer Screening

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