Revista de Métodos de Diagnóstico Médico
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Clinical and Radiological Considerations for Incorporating Computed Tomographic Colonography into Colorectal Cancer Screening Programs

Fajardo Laurie L, Han Fang Wei and Brown Bruce P

Colorectal cancer is the third most common type of cancer and the second leading cause of cancer death in the United States. Clinical evidence amassed over the last several decades indicates that routine screening, compared to no screening, detects the disease at an earlier stage, and reduces the incidence of colorectal cancer by interrupting the adenoma-to-carcinoma sequence in colon polyps through colonoscopy-guided polypectomy and thus reduces mortality. Guidelines for screening include fecal occult blood testing, sigmoidoscopy, colonoscopy and – most recently – computed tomographic colonography. This review discusses each modality and the current recommendations and state of the art for colorectal cancer screening. Properly implemented in a multi-modality disease prevention and screening setting, computed tomographic colonography provides an appealing alternative to traditional optical colonoscopy for screening in populations unwilling or unable to undergo colonoscopy, thus potentially increasing screening rates and reducing colorectal cancer incidence and mortality.