| Theme |
Strategy of colon cancer screening |
| Title |
CT air contrast enema and CT colonoscopy for colorectal cancer screening -- Not yet ready for routine clinical use in Japan |
| Author |
Koichi Nagata |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Shungo Endo |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Shin-ei Kudo |
Digestive Disease Center, Showa University Northern Yokohama Hospital |
| Author |
Keisuke Dasai |
Radiology Section, Showa University Northern Yokohama Hospital |
| Author |
Katsuyuki Moriya |
Radiology Section, Showa University Northern Yokohama Hospital |
| [ Summary ] |
Colorectal cancer screening, by means of fecal occult blood tests (FOBT), conventional colonoscopy, and barium enema X-rays is generally accepted and has proven to be effective in reducing colorectal cancer incidence and mortality in Japan. Conventional colonoscopy is the best available method for detection of colorectal cancer. The level of technology and popularity of conventional endoscopy in Japan is among the highest in the world. But, new ideal screening examinations, with high sensitivity / specificity, comfort, ease, minimal invasiveness, and low cost are required. In North America and Europe, the clinical application ofCT colonography for colorectal cancer screening has started. 3D-CT has advantages and disadvantages in the detection of colorectal cancer. 3D-CT, as a type of preoperative examination, has high sensitivity and specificity for detection of colorectal cancer. 3D-CT is a less invasive examination compared to barium enema X-rays and conventional colonoscopy. However, CT enemas and CT colonography are still inferior to colonoscopic examination for the diagnosis of colorectal cancer, especially for flat lesions. Before 3D-CT can be generally recommended for colorectal cancer screening in Japan, further improvements in the detection of flat and small lesions must be achieved. |