| Abstract [eng] |
About half of million deaths caused by colorectal cancer (CRC) has been reported worldwide every year. Programmes for early diagnosis of CRC has reduced mortality due to this disease, as the cancer is diagnosed in earlier stages which can be treated more successfully. Programme for early CRC diagnosis in Lithuania has been based on the faeces occult blood test (FOBT). If positive FOBT result is obtained, patients should be referred for colonoscopy (CS) examination. Based on the data from the National Health Fund, during the first three years CS examination was carried out for a little bit more than half of the patients participating in the programme and presenting with positive FOBT result. Aiming to improve accuracy of CRC diagnostics we have suggested alternative CS examination – computed tomography colonography (CTC). The aim of our study was to establish diagnostic value of CTC examination in the identification of neoplastic alterations in the patients with positive FOBT result and to specify factors having influence on the examination quality. CTC examinations were carried out and their results were compared with the findings of CS. We discovered that CTC is of high diagnostic value for detection of lesions sized ≥ 6 mm and of very high diagnostic value for detection of large ( ≥ 10 mm) polyps in a colon. We found out that the length of colon had no influence on how patients tolerated this examination and on patients well-being during CTC procedure, and colon cleaning quality before CTC procedure was not associated with the anatomical peculiarities of colon, such as length of a gut. We established that CTC is a sensitive examination to detect neoplastic colorectal adenoma and cancer, however does not reach sensitivity of CS examination, therefore we do not recommend CTC as the first choice examination method for the patients of studied group. Considering the results of our study, we recommend CTC examination for the patients with positive FOBT results, to whom CS examination is inappropriate. |
