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

https://doi.org/10.1136/ebm.10.4.124

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    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.
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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 ★★★★★☆☆

    METHODS

    Embedded ImageDesign:

    blinded comparison of ACBE, CTC, and colonoscopy.

    Embedded ImageSetting:

    14 centres in the US.

    Embedded ImagePatients:

    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.

    Embedded ImageDescription 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 …

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    Footnotes

    • For correspondence: Dr D C Rockey, Duke University Medical Center, Durham, NC, USA. dcrockeyacpub.duke.edu

    • Source of funding: National Cancer Institute.