Reassessing the role of radiology in Hemoccult screening.
During a recent regional screening program, 98 patients with a positive Hemoccult test were evaluated radiographically. Double-contrast barium enema (DCBE) detected all six carcinomas and 92% of 37 polyps. DCBE was also the most cost-effective procedure. Colonoscopy dramatically increased screening costs without providing evidence to support its use in all Hemoccult-positive patients. It is recommended that DCBE be the initial diagnostic test in Hemoccult-positive patients, to be supplemented in selected patients by flexible sigmoidoscopy or colonoscopy depending on the pathology evident on DCBE and on clinical circumstances.
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000000981:diagnostic imaging*; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009780:Occult Blood; D011859:Radiography; D012004:Rectal Neoplasms / Q000000981:diagnostic imaging*