All authors were involved in the conception and design or the analysis and interpretation of data; drafting the article or revising it critically for important intellectual content; and final approval of the version to be published. The first two authors had full access to all data in the study, and the last author had final responsibility for the decision to submit for publication.
Computed tomographic colonography for colorectal cancer screening
Risk factors for the detection of advanced neoplasia
Article first published online: 10 JUN 2013
© 2013 American Cancer Society
Volume 119, Issue 14, pages 2549–2554, 15 July 2013
How to Cite
Hassan, C., Pooler, B. D., Kim, D. H., Rinaldi, A., Repici, A. and Pickhardt, P. J. (2013), Computed tomographic colonography for colorectal cancer screening. Cancer, 119: 2549–2554. doi: 10.1002/cncr.28007
- Issue published online: 1 JUL 2013
- Article first published online: 10 JUN 2013
- Manuscript Accepted: 3 JAN 2013
- Manuscript Revised: 22 DEC 2012
- Manuscript Received: 27 NOV 2012
- advanced adenomas;
- advanced neoplasia;
- computed tomographic colonography;
- colorectal cancer prevention;
- colorectal cancer screening
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).
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.
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.
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. Cancer 2013;119:2549–2554. © 2013 American Cancer Society.