However, 2 patients with 4- and 10-mm polyps reported on DCBE underwent repeat colonoscopy, and no polyps were found. The remaining 3 patients with polyps reported on DCBE refused repeat colonoscopy. Thirteen patients whose DCBE studies were reported as of suboptimal quality underwent repeat colonoscopy, and 5 patients were found to have polyps (one 1-cm tubular adenoma, 4 <5-mm hyperplastic polyps). In a study of 103 patients who underwent DCBE performed immediately after incomplete colonoscopy, the entire colon was visualized in 94% of subjects [102]. Five malignant neoplasms (size not reported) were identified at DCBE [102]. SCBE Very limited data are available regarding the accuracy of SCBE performed after incomplete colonoscopy. In a study of 118 patients who underwent barium enema following incomplete colonoscopy (103 double contrast, 15 single contrast), 2 polyps were found (4 and 5 mm) and removed at subsequent repeat colonoscopy [103]. Repeat colonoscopic findings were not available for the vast majority of study subjects [103]. Summary of Recommendations For average-risk individuals, CT colonography is usually appropriate for colorectal cancer screening. For moderate-risk individuals (eg, first-degree family history of cancer or adenoma), CT colonography is usually appropriate for colorectal cancer screening. For moderate-risk individuals after positive FOBT or positive fecal immunochemical test, CT colonography is usually appropriate for colorectal cancer detection. For high-risk individuals (eg, hereditary nonpolyposis colorectal cancer, ulcerative colitis, or Crohn colitis), colonoscopy is preferred over imaging tests because of its ability to obtain biopsies to look for dysplasia. For colorectal cancer screening after incomplete colonoscopy, CT colonography is usually appropriate for individuals at average, moderate, or high risk for colorectal cancer. Colorectal Cancer Screening
Colorectal Cancer Screening. However, 2 patients with 4- and 10-mm polyps reported on DCBE underwent repeat colonoscopy, and no polyps were found. The remaining 3 patients with polyps reported on DCBE refused repeat colonoscopy. Thirteen patients whose DCBE studies were reported as of suboptimal quality underwent repeat colonoscopy, and 5 patients were found to have polyps (one 1-cm tubular adenoma, 4 <5-mm hyperplastic polyps). In a study of 103 patients who underwent DCBE performed immediately after incomplete colonoscopy, the entire colon was visualized in 94% of subjects [102]. Five malignant neoplasms (size not reported) were identified at DCBE [102]. SCBE Very limited data are available regarding the accuracy of SCBE performed after incomplete colonoscopy. In a study of 118 patients who underwent barium enema following incomplete colonoscopy (103 double contrast, 15 single contrast), 2 polyps were found (4 and 5 mm) and removed at subsequent repeat colonoscopy [103]. Repeat colonoscopic findings were not available for the vast majority of study subjects [103]. Summary of Recommendations For average-risk individuals, CT colonography is usually appropriate for colorectal cancer screening. For moderate-risk individuals (eg, first-degree family history of cancer or adenoma), CT colonography is usually appropriate for colorectal cancer screening. For moderate-risk individuals after positive FOBT or positive fecal immunochemical test, CT colonography is usually appropriate for colorectal cancer detection. For high-risk individuals (eg, hereditary nonpolyposis colorectal cancer, ulcerative colitis, or Crohn colitis), colonoscopy is preferred over imaging tests because of its ability to obtain biopsies to look for dysplasia. For colorectal cancer screening after incomplete colonoscopy, CT colonography is usually appropriate for individuals at average, moderate, or high risk for colorectal cancer. Colorectal Cancer Screening