An older investigation of screening with colonoscopy or sigmoidoscopy and DCBE compared to no screening found a reduction in colorectal cancer incidence with screening in families with hereditary nonpolyposis colorectal cancer [79]. SCBE SCBE generally does not perform as well as DCBE for detection of polyps and cancers and should be used if CTC or DCBE cannot be performed. Limited evidence is available regarding the performance of SCBE in individuals with a family history of colorectal cancer. Colorectal Cancer Screening In studies comparing DCBE to endoscopy, when used to evaluate individuals with a positive FOBT, most reports indicate a sensitivity of 75% to 80% [85,86]. In a study comparing DCBE to endoscopy in 71 patients with rectal bleeding, the sensitivity of DCBE for detecting adenomas >6 mm was 58% [87]. SCBE SCBE generally does not perform as well as DCBE for detection of polyps and cancers and should be used if CTC or DCBE cannot be performed. In a retrospective evaluation of 165 patients who underwent SCBE, the sensitivity for colorectal cancer was 81.8% [66]. The majority of these patients were symptomatic (eg, bleeding, anemia, altered bowel habit) at time of imaging [66]. In a FOBT trial, SCBE was used as a diagnostic follow-up and the sensitivity for cancer was 80% [88]. Variant 4: Colorectal cancer screening. High-risk individual. Hereditary nonpolyposis colorectal cancer; ulcerative colitis or Crohn colitis. The risk of cancer in individuals with ulcerative colitis increases after the disease has been present 8 to 10 years, and it correlates with the extent of the disease. The cumulative probability of colorectal cancer in an ulcerative colitis patient is 2% by 10 years, 8% by 20 years, and 18% by 30 years [91]. The risk for individuals with Crohn colitis may be comparable.
Colorectal Cancer Screening. An older investigation of screening with colonoscopy or sigmoidoscopy and DCBE compared to no screening found a reduction in colorectal cancer incidence with screening in families with hereditary nonpolyposis colorectal cancer [79]. SCBE SCBE generally does not perform as well as DCBE for detection of polyps and cancers and should be used if CTC or DCBE cannot be performed. Limited evidence is available regarding the performance of SCBE in individuals with a family history of colorectal cancer. Colorectal Cancer Screening In studies comparing DCBE to endoscopy, when used to evaluate individuals with a positive FOBT, most reports indicate a sensitivity of 75% to 80% [85,86]. In a study comparing DCBE to endoscopy in 71 patients with rectal bleeding, the sensitivity of DCBE for detecting adenomas >6 mm was 58% [87]. SCBE SCBE generally does not perform as well as DCBE for detection of polyps and cancers and should be used if CTC or DCBE cannot be performed. In a retrospective evaluation of 165 patients who underwent SCBE, the sensitivity for colorectal cancer was 81.8% [66]. The majority of these patients were symptomatic (eg, bleeding, anemia, altered bowel habit) at time of imaging [66]. In a FOBT trial, SCBE was used as a diagnostic follow-up and the sensitivity for cancer was 80% [88]. Variant 4: Colorectal cancer screening. High-risk individual. Hereditary nonpolyposis colorectal cancer; ulcerative colitis or Crohn colitis. The risk of cancer in individuals with ulcerative colitis increases after the disease has been present 8 to 10 years, and it correlates with the extent of the disease. The cumulative probability of colorectal cancer in an ulcerative colitis patient is 2% by 10 years, 8% by 20 years, and 18% by 30 years [91]. The risk for individuals with Crohn colitis may be comparable.