Colonoscopy detected colon polyps better than air contrast barium enema or computed tomographic colonography

doi:10.1136/ebm.10.4.124

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Evidence-Based Medicine 2005;10:124; doi:10.1136/ebm.10.4.124
Copyright © 2005 by the BMJ Publishing Group Ltd.

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Colonoscopy detected colon polyps better than air contrast barium enema or computed tomographic colonography

Rockey DC, Paulson E, Niedzwiecki D, et al. Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet 2005;365:305–11.[Medline]

Q In patients at high risk of colonic neoplasia, what is the comparative accuracy of air contrast barium enema (ACBE), computed tomographic colonography (CTC), and colonoscopy for detecting large colonic polyps?

Clinical impact ratings GP/FP/Primary care $*$ $*$ $*$ $*$ $*$ $*$ ${star}$ IM/Ambulatory care $*$ $*$ $*$ $*$ $*$ ${star}$ ${star}$ Internal medicine $*$ $*$ $*$ $*$ $*$ ${star}$ ${star}$ Oncology $*$ $*$ $*$ $*$ ${star}$ ${star}$ ${star}$ Gastroenterology $*$ $*$ $*$ $*$ $*$ ${star}$ ${star}$

Key Words: barium sulphate • colonic neoplasms • colonic polyps • colonoscopy • enema

The first 150 words of the full text of this article appear below.

METHODS
Design: blinded comparison of ACBE, CTC, and colonoscopy.

Setting: 14 centres in the US.

Patients: 614 patients (mean age 57 y, 70% men) with $>=$ 1 positive test resultfor faecal occult blood, $>=$ 1 episode of bright red blood per rectumin the previous 3 months, iron deficiency anaemia, or a familyhistory of colon cancer or adenoma. Exclusion criteria includedactive gastrointestinal haemorrhage and serious medical illness.

Description of tests: ACBE was done according to standard protocols. Before ACBE,patients were given bisacodyl tablets and a suppository. Afterinfusion of high density barium and distension of the colonwith room air, spot films were taken of all specific colon segmentsand overhead radiographs were obtained in various positions.7–14 days after ACBE, CTC and colonoscopy were done onthe same day. Patients were prepared for CTC with a phosphatebased cathartic. After placement of a rectal tube, the colonwas . . . [Full text of this article]

Virender K Sharma, MD, Cuong C Nguyen, MD

Mayo Clinic Arizona, Scottsdale, Arizona, USA