Frequency and impact of extracolonic findings detected at computed tomographic colonography in a symptomatic population.
BACKGROUND
Extracolonic findings are frequently recognized alongside colonic pathology at computed tomographic colonography (CTC). This study assessed the clinical impact of extracolonic findings in a symptomatic population at high risk of colorectal cancer.


METHODS
CTC was performed in a consecutive cohort of patients assessed in a fast-track colorectal cancer clinic as being at high risk of colorectal cancer. A review of CTC findings and case notes was undertaken. Patients with extracolonic findings were followed up for at least 12 months.


RESULTS
Thirty-one (13.8 per cent) of 225 patients investigated by CTC had colorectal cancer. Extracolonic findings were identified in 81 (53.3 per cent) of 152 patients with normal or non-neoplastic bowel findings, compared with 27 (37 per cent) of 73 patients with colorectal neoplasia (P = 0.025). Twenty-four patients (10.7 per cent) with extracolonic findings underwent further investigation or treatment. The median duration of investigation was 19.5 weeks. Seventy-five clinical events were recorded, including 14 surgical procedures.


CONCLUSIONS
A prospective cost-benefit analysis of diagnostic CTC should be performed before it is established as a first-line investigation for colonic symptoms.
Khan
K Y
KY
Department of Surgery, Queen Elizabeth Hospital, University of Birmingham, Birmingham, UK.
Xiong
T
T
McCafferty
I
I
Riley
P
P
Ismail
T
T
Lilford
R J
RJ
Morton
D G
DG
D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D023881:Colonography, Computed Tomographic / Q000191:economics; D015179:Colorectal Neoplasms / Q000150:complications / Q000000981:diagnostic imaging* / Q000191:economics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors