title: Computer tomography colonography participation and yield in patients under surveillance for 6-9 mm polyps in a population-based screening trial.
abstract: OBJECTIVE
  Surveillance CT colonography (CTC) is a viable option for 6-9 mm polyps at CTC screening for colorectal cancer. We established participation and diagnostic yield of surveillance and determined overall yield of CTC screening.
  
  
  METHODS
  In an invitational CTC screening trial 82 of 982 participants harboured 6-9 mm polyps as the largest lesion(s) for which surveillance CTC was advised. Only participants with one or more lesion(s) ≥6 mm at surveillance CTC were offered colonoscopy (OC); 13 had undergone preliminary OC. The surveillance CTC yield was defined as the number of participants with advanced neoplasia in the 82 surveillance participants, and was added to the primary screening yield.
  
  
  RESULTS
  Sixty-five of 82 participants were eligible for surveillance CTC of which 56 (86.2 %) participated. Advanced neoplasia was diagnosed in 15/56 participants (26.8 %) and 9/13 (69.2 %) with preliminary OC. Total surveillance yield was 24/82 (29.3 %). No carcinomas were detected. Adding surveillance results to initial screening CTC yield significantly increased the advanced neoplasia yield per 100 CTC participants (6.1 to 8.6; p < 0.001) and per 100 invitees (2.1 to 2.9; p < 0.001).
  
  
  CONCLUSIONS
  Surveillance CTC for 6-9 mm polyps has a substantial yield of advanced adenomas and significantly increased the CTC yield in population screening.
  
  
  CONCLUSIONS
  • The participation rate in surveillance CT colonography (CTC) is 86 %. • Advanced adenoma prevalence in a 6-9 mm CTC surveillance population is high. • Surveillance CTC significantly increases the yield of population screening by CTC. • Surveillance CTC for 6-9 mm polyps is a safe strategy. • Surveillance CTC is unlikely to yield new important extracolonic findings.
authors.affiliation: Department of Radiology, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DD, Amsterdam, The Netherlands. c.j.tuteinnolthenius@amc.uva.nl.|Department of Radiology, Onze Lieve Vrouwe Gasthuis, PO Box 95500, 1090 HM, Amsterdam, The Netherlands. c.j.tuteinnolthenius@amc.uva.nl.|Department of Radiology, G1-215, Academic Medical Center, PO Box 22660, 1100 DD, Amsterdam, The Netherlands. c.j.tuteinnolthenius@amc.uva.nl.
authors.forename: Charlotte J
authors.initials: CJ
authors.lastname: Tutein Nolthenius
authors.affiliation: Department of Radiology, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DD, Amsterdam, The Netherlands.
authors.forename: Thierry N
authors.initials: TN
authors.lastname: Boellaard
authors.affiliation: Department of Radiology, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
authors.forename: Margriet C
authors.initials: MC
authors.lastname: de Haan
authors.affiliation: Department of Radiology, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DD, Amsterdam, The Netherlands.
authors.forename: C Yung
authors.initials: CY
authors.lastname: Nio
authors.affiliation: Department of Radiology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Maarten G J
authors.initials: MG
authors.lastname: Thomeer
authors.affiliation: Department of Radiology, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DD, Amsterdam, The Netherlands.
authors.forename: Shandra
authors.initials: S
authors.lastname: Bipat
authors.affiliation: Department of Radiology, Onze Lieve Vrouwe Gasthuis, PO Box 95500, 1090 HM, Amsterdam, The Netherlands.
authors.forename: Alexander D
authors.initials: AD
authors.lastname: Montauban van Swijndregt
authors.affiliation: Department of Pathology, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DD, Amsterdam, The Netherlands.
authors.forename: Marc J
authors.initials: MJ
authors.lastname: van de Vijver
authors.affiliation: Department of Pathology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Katharina
authors.initials: K
authors.lastname: Biermann
authors.affiliation: Department of Gastroenterology and Hepatology, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.|Department of Internal Medicine, Erasmus University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
authors.forename: Ernst J
authors.initials: EJ
authors.lastname: Kuipers
authors.affiliation: Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DD, Amsterdam, The Netherlands.
authors.forename: Evelien
authors.initials: E
authors.lastname: Dekker
authors.affiliation: Department of Radiology, Academic Medical Center, University of Amsterdam, PO Box 22700, 1100 DD, Amsterdam, The Netherlands.
authors.forename: Jaap
authors.initials: J
authors.lastname: Stoker
mesh_terms: D000368:Aged; D003111:Colonic Polyps / Q000175:diagnosis* / Q000453:epidemiology; D023881:Colonography, Computed Tomographic / Q000379:methods*; D003113:Colonoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D011159:Population Surveillance; D015995:Prevalence
keywords: Colonic polyps; Colonography, computed tomographic/methods; Colorectal neoplasms/diagnosis; Mass screening/methods; Patient participation