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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 ★★★★★★☆ IM/Ambulatory care ★★★★★☆☆ Internal medicine ★★★★★☆☆ Oncology ★★★★☆☆☆ Gastroenterology ★★★★★☆☆
blinded comparison of ACBE, CTC, and colonoscopy.
14 centres in the US.
614 patients (mean age 57 y, 70% men) with ⩾1 positive test result for faecal occult blood, ⩾1 episode of bright red blood per rectum in the previous 3 months, iron deficiency anaemia, or a family history of colon cancer or adenoma. Exclusion criteria included active 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. After infusion of high density barium and distension of the colon with room air, spot films were taken of all specific colon …
For correspondence: Dr D C Rockey, Duke University Medical Center, Durham, NC, USA.
Source of funding: National Cancer Institute.