Sensitivity and specificity of CT colonography for the detection of colonic neoplasia after positive faecal occult blood testing: systematic review and meta-analysis.
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| Title: | Sensitivity and specificity of CT colonography for the detection of colonic neoplasia after positive faecal occult blood testing: systematic review and meta-analysis. |
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| Authors: | Plumb, Andrew1, Halligan, Steve s.halligan@ucl.ac.uk, Pendsé, Douglas1, Taylor, Stuart1, Mallett, Susan2 |
| Source: | European Radiology. May2014, Vol. 24 Issue 5, p1049-1058. 10p. 1 Diagram, 5 Charts, 2 Graphs. |
| Subjects: | Computed tomography, Fecal occult blood tests, Colonoscopy, Colon examination, Colon cancer diagnosis |
| Abstract: | Objective: CT colonography (CTC) is recommended after positive faecal occult blood testing (FOBt) when colonoscopy is incomplete or infeasible. We aimed to estimate the sensitivity and specificity of CTC for colorectal cancer and adenomatous polyps following positive FOBt via systematic review. Methods: The MEDLINE, EMBASE, AMED and Cochrane Library databases were searched for CTC studies reporting sensitivity and specificity for colorectal cancer and adenomatous polyps. Included subjects had tested FOBt-positive by guaiac or immunochemical methods. Per-patient detection rates were summarized via forest plots. Meta-analysis of sensitivity and specificity was conducted using a bivariate random effects model and the average operating point calculated. Results: Of 538 articles considered, 5 met inclusion criteria, describing results from 622 patients. Research study quality was good. CTC had a high per-patient average sensitivity of 88.8 % (95 % CI 83.6 to 92.5 %) for ≥6 mm adenomas or colorectal cancer, with low between-study heterogeneity. Specificity was both more heterogeneous and lower, at an average of 75.4 % (95 % CI 58.6 to 86.8 %). Conclusion: Few studies have investigated CTC in FOBt-positive individuals. CTC is sensitive at a ≥6 mm threshold but specificity is lower and variable. Despite the limited data, these results suggest that CTC may adequately substitute for colonoscopy when the latter is undesirable. Key Points: • FOBt is the most common mass screening test for colorectal cancer. • Few studies evaluate CT colonography after positive FOBt. • CTC is approximately 89 % sensitive for ≥6 mm adenomas/cancer in this setting. • Specificity is lower, at approximately 75 %, and more variable. • CT colonography is a good alternative when colonoscopy is undesirable. [ABSTRACT FROM AUTHOR] |
| Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) | |
| Database: | Engineering Source |
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| Items | – Name: Title Label: Title Group: Ti Data: Sensitivity and specificity of CT colonography for the detection of colonic neoplasia after positive faecal occult blood testing: systematic review and meta-analysis. – Name: Author Label: Authors Group: Au Data: <searchLink fieldCode="AR" term="%22Plumb%2C+Andrew%22">Plumb, Andrew</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Halligan%2C+Steve%22">Halligan, Steve</searchLink><i> s.halligan@ucl.ac.uk</i><br /><searchLink fieldCode="AR" term="%22Pendsé%2C+Douglas%22">Pendsé, Douglas</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Taylor%2C+Stuart%22">Taylor, Stuart</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Mallett%2C+Susan%22">Mallett, Susan</searchLink><relatesTo>2</relatesTo> – Name: TitleSource Label: Source Group: Src Data: <searchLink fieldCode="JN" term="%22European+Radiology%22">European Radiology</searchLink>. May2014, Vol. 24 Issue 5, p1049-1058. 10p. 1 Diagram, 5 Charts, 2 Graphs. – Name: Subject Label: Subjects Group: Su Data: <searchLink fieldCode="DE" term="%22Computed+tomography%22">Computed tomography</searchLink><br /><searchLink fieldCode="DE" term="%22Fecal+occult+blood+tests%22">Fecal occult blood tests</searchLink><br /><searchLink fieldCode="DE" term="%22Colonoscopy%22">Colonoscopy</searchLink><br /><searchLink fieldCode="DE" term="%22Colon+examination%22">Colon examination</searchLink><br /><searchLink fieldCode="DE" term="%22Colon+cancer+diagnosis%22">Colon cancer diagnosis</searchLink> – Name: Abstract Label: Abstract Group: Ab Data: Objective: CT colonography (CTC) is recommended after positive faecal occult blood testing (FOBt) when colonoscopy is incomplete or infeasible. We aimed to estimate the sensitivity and specificity of CTC for colorectal cancer and adenomatous polyps following positive FOBt via systematic review. Methods: The MEDLINE, EMBASE, AMED and Cochrane Library databases were searched for CTC studies reporting sensitivity and specificity for colorectal cancer and adenomatous polyps. Included subjects had tested FOBt-positive by guaiac or immunochemical methods. Per-patient detection rates were summarized via forest plots. Meta-analysis of sensitivity and specificity was conducted using a bivariate random effects model and the average operating point calculated. Results: Of 538 articles considered, 5 met inclusion criteria, describing results from 622 patients. Research study quality was good. CTC had a high per-patient average sensitivity of 88.8 % (95 % CI 83.6 to 92.5 %) for ≥6 mm adenomas or colorectal cancer, with low between-study heterogeneity. Specificity was both more heterogeneous and lower, at an average of 75.4 % (95 % CI 58.6 to 86.8 %). Conclusion: Few studies have investigated CTC in FOBt-positive individuals. CTC is sensitive at a ≥6 mm threshold but specificity is lower and variable. Despite the limited data, these results suggest that CTC may adequately substitute for colonoscopy when the latter is undesirable. Key Points: • FOBt is the most common mass screening test for colorectal cancer. • Few studies evaluate CT colonography after positive FOBt. • CTC is approximately 89 % sensitive for ≥6 mm adenomas/cancer in this setting. • Specificity is lower, at approximately 75 %, and more variable. • CT colonography is a good alternative when colonoscopy is undesirable. [ABSTRACT FROM AUTHOR] – Name: AbstractSuppliedCopyright Label: Group: Ab Data: <i>Copyright of European Radiology is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.) |
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| RecordInfo | BibRecord: BibEntity: Identifiers: – Type: doi Value: 10.1007/s00330-014-3106-0 Languages: – Code: eng Text: English PhysicalDescription: Pagination: PageCount: 10 StartPage: 1049 Subjects: – SubjectFull: Computed tomography Type: general – SubjectFull: Fecal occult blood tests Type: general – SubjectFull: Colonoscopy Type: general – SubjectFull: Colon examination Type: general – SubjectFull: Colon cancer diagnosis Type: general Titles: – TitleFull: Sensitivity and specificity of CT colonography for the detection of colonic neoplasia after positive faecal occult blood testing: systematic review and meta-analysis. Type: main BibRelationships: HasContributorRelationships: – PersonEntity: Name: NameFull: Plumb, Andrew – PersonEntity: Name: NameFull: Halligan, Steve – PersonEntity: Name: NameFull: Pendsé, Douglas – PersonEntity: Name: NameFull: Taylor, Stuart – PersonEntity: Name: NameFull: Mallett, Susan IsPartOfRelationships: – BibEntity: Dates: – D: 01 M: 05 Text: May2014 Type: published Y: 2014 Identifiers: – Type: issn-print Value: 09387994 Numbering: – Type: volume Value: 24 – Type: issue Value: 5 Titles: – TitleFull: European Radiology Type: main |
| ResultId | 1 |
