Computed tomographic colonography for colorectal cancer screening. Issue 14 (10th June 2013)

• Record Type: Journal Article
• Authors: Hassan, Cesare; Pooler, B. Dustin; Kim, David H.; Rinaldi, Antonio; Repici, Alessandro; Pickhardt, Perry J.
• Is Part Of: Cancer. Volume 119:Issue 14(2013)
• Page Start: 2549
• Page End: 2554
• Publication Date: 2013-06-10
• Subjects: Cancer -- Periodicals; Cancer -- Cytopathology -- Periodicals; 616.99405
• DOI: 10.1002/cncr.28007
• Languages: English
• ISSNs: 0008-543X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="cncr28007-sec-0001" sec-type="section"> <title>BACKGROUND</title> <p>The objective of this study was to determine whether age, sex, a positive family history of colorectal cancer, and body mass index (BMI) are important predictors of advanced neoplasia in the setting of screening computed tomographic colonography (CTC).</p> </sec> <sec id="cncr28007-sec-0002" sec-type="section"> <title>METHODS</title> <p>Consecutive patients who were referred for first‐time screening CTC from 2004 to 2011 at a single medical center were enrolled. Results at pathology were recorded for all patients who underwent polypectomy. Logistic regression was used to identify significant predictor variables for advanced neoplasia (any adenoma ≥10 mm or with villous component, high‐grade dysplasia, or adenocarcinoma). Odds ratios (ORs) were used to express associations between the study variables (age, sex, BMI, and a positive family history of colorectal cancer) and advanced neoplasia.</p> </sec> <sec id="cncr28007-sec-0003" sec-type="section"> <title>RESULTS</title> <p>In total, 7620 patients underwent CTC screening. Of these, 276 patients (3.6%; 95% confidence interval [CI], 3.2%‐4.1%) ultimately were diagnosed with advanced neoplasia. At multivariate analysis, age (mean OR per 10‐year increase, 1.8; 95% CI, 1.6‐2.0) and being a man (OR, 1.7; 95% CI, 1.3‐2.2) were independent predictors of advanced neoplasia, whereas BMI and a positive family history of colorectal cancer were not. The number needed to screen to detect 1 case of advanced neoplasia varied from 51 among women aged ≤55 years to 10 among men aged >65 years. The number of post‐CTC colonoscopies needed to detect 1 case of advanced neoplasia varied from 2 to 4.</p> </sec> <sec id="cncr28007-sec-0004" sec-type="section"> <title>CONCLUSIONS</title> <p>Age and sex were identified as important independent predictors of advanced neoplasia risk in individuals undergoing screening CTC, whereas BMI and a positive family history of colorectal cancer were not. These results have implications for appropriate patient selection. <bold><italic>Cancer</italic> 2013;119:2549–2554</bold>. © <italic>2013 American Cancer Society</italic>.</p> </sec> </abstract>