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Can Computed Tomographic Colonography Become a “Good” Screening Test?

Thomas F. Imperiale, MD
[+] Article, Author, and Disclosure Information

From Indiana University Medical Center, Indianapolis, IN 46202-5102.

Potential Financial Conflicts of Interest: Consultancies and grant support (Exact Sciences).

Requests for Single Reprints: Thomas F. Imperiale, MD, The Regenstrief Institute, Inc., 1050 Wishard Boulevard, Indianapolis, IN 46202-5102.

Ann Intern Med. 2005;142(8):669-670. doi:10.7326/0003-4819-142-8-200504190-00017
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In the not-too-distant future, I'll have to decide about colorectal cancer screening—as a patient. Despite my first-hand witness to the benefits of colonoscopy, I am seriously considering computed tomographic colonography (CTC) (“virtual colonoscopy”). A recent study of CTC without bowel preparation reported a sensitivity of 90% and specificity of 92% for polyps 8 mm or larger (1). This test appeals to me because I can avoid the preparation, conscious sedation, discomfort, and risk for perforation. These inconveniences collectively cross my threshold for what a “good” screening test should be. A recent multicenter study of CTC reporting a sensitivity of 59% for polyps 9 mm or larger in diameter may cause me to reconsider, however (2).

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