Journal of the American College of Radiology
Volume 7, Issue 9 , Pages 670-678 , September 2010

ACR Appropriateness Criteria® on Colorectal Cancer Screening

  • Judy Yee, MD

      Affiliations

    • University of California San Francisco, San Francisco, California
    • Corresponding Author InformationCorresponding author and reprints: Judy Yee, MD, University of California, San Francisco/VA Medical Center, 4150 Clement Street, (114), San Francisco, CA 94121
    • ,
  • Max Paul Rosen, MD, MPH

      Affiliations

    • Beth Israel Deaconess Medical Center, Boston, Massachusetts
    • ,
  • Michael A. Blake, MB, BCh

      Affiliations

    • Massachusetts General Hospital, Boston, Massachusetts
    • ,
  • Mark E. Baker, MD

      Affiliations

    • Cleveland Clinic, Cleveland, Ohio
    • ,
  • Brooks D. Cash, MD

      Affiliations

    • National Naval Medical Center, Bethesda, Maryland
    • American Gastroenterological Association, Bethesda, Maryland
    • ,
  • Jeff L. Fidler, MD

      Affiliations

    • Mayo Clinic, Rochester, Minnesota
    • ,
  • Thomas H. Grant, DO

      Affiliations

    • Northwestern Medical Faculty, Chicago, Illinois
    • ,
  • Frederick L. Greene, MD

      Affiliations

    • Carolinas Medical Center, Charlotte, North Carolina
    • American College of Surgeons, Chicago, Illinois
    • ,
  • Bronwyn Jones, MD

      Affiliations

    • Johns Hopkins Hospital, Baltimore, Maryland
    • ,
  • Douglas S. Katz, MD

      Affiliations

    • Winthrop University Hospital, Mineola, New York
    • ,
  • Tasneem Lalani, MD

      Affiliations

    • Inland Imaging Associates, Seattle, Washington
    • University of Washington, Seattle, Washington
    • ,
  • Frank H. Miller, MD

      Affiliations

    • Northwestern University Feinberg School of Medicine/NMH, Chicago, Illinois
    • ,
  • William C. Small, MD, PhD

      Affiliations

    • Emory University, Atlanta, Georgia
    • ,
  • Gary S. Sudakoff, MD

      Affiliations

    • Medical College of Wisconsin, Milwaukee, Wisconsin
    • ,
  • David M. Warshauer, MD

      Affiliations

    • University of North Carolina School of Medicine, Chapel Hill, North Carolina

References 

  1. Hofstad B, Vatn M. Growth rate of colon polyps and cancer. Gastrointest Endosc Clin N Am. 1997;7:345–363
  2. Winawer SJ, Zauber AG, Ho MN, et al. National Polyp Study Workgroup Prevention of colorectal cancer by colonoscopic polypectomy. N Engl J Med. 1993;329:1977–1981
  3. Hardcastle JD, Chamberlain JO, Robinson MH, et al. Randomised controlled trial of faecal-occult-blood screening for colorectal cancer. Lancet. 1996;348:1472–1477
  4. Kronborg O, Fenger C, Olsen J, Jorgensen OD, Sondergaard O. Randomised study of screening for colorectal cancer with faecal-occult-blood test. Lancet. 1996;348:1467–1471
  5. Mandel JS, Bond JH, Church TR, et al. Reducing mortality from colorectal cancer by screening for fecal occult blood (Minnesota Colon Cancer Control Study). N Engl J Med. 1993;328:1365–1371
  6. Selby JV, Friedman GD, Quesenberry CP, Weiss NS. A case-control study of screening sigmoidoscopy and mortality from colorectal cancer. N Engl J Med. 1992;326:653–657
  7. Muller AD, Sonnenberg A. Protection by endoscopy against death from colorectal cancer (A case-control study among veterans). Arch Intern Med. 1995;155:1741–1748
  8. Muto T, Bussey HJ, Morson BC. The evolution of cancer of the colon and rectum. Cancer. 1975;36:2251–2270
  9. Stryker SJ, Wolff BG, Culp CE, Libbe SD, Ilstrup DM, MacCarty RL. Natural history of untreated colonic polyps. Gastroenterology. 1987;93:1009–1013
  10. Levin B, Lieberman DA, McFarland B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin. 2008;58:130–160
  11. Jarvinen HJ, Mecklin JP, Sistonen P. Screening reduces colorectal cancer rate in families with hereditary nonpolyposis colorectal cancer. Gastroenterology. 1995;108:1405–1411
  12. Winawer S, Fletcher R, Rex D, et al. Colorectal cancer screening and surveillance: clinical guidelines and rationale-Update based on new evidence. Gastroenterology. 2003;124:544–560
  13. Whitlock EP, Lin JS, Liles E, Beil TL, Fu R. Screening for colorectal cancer: a targeted, updated systematic review for the U.S. Preventive Services Task Force. Ann Intern Med. 2008;149:638–658
  14. Pignone M, Rich M, Teutsch SM, Berg AO, Lohr KN. Screening for colorectal cancer in adults at average risk: a summary of the evidence for the U.S. Preventive Services Task Force. Ann Intern Med. 2002;137:132–141
  15. Kung JW, Levine MS, Glick SN, Lakhani P, Rubesin SE, Laufer I. Colorectal cancer: screening double-contrast barium enema examination in average-risk adults older than 50 years. Radiology. 2006;240:725–735
  16. Betes M, Munoz-Navas MA, Duque JM, et al. Use of colonoscopy as a primary screening test for colorectal cancer in average risk people. Am J Gastroenterol. 2003;98:2648–2654
  17. Harewood GC, Lieberman DA. Prevalence of advanced neoplasia at screening colonoscopy in men in private practice versus academic and Veterans Affairs medical centers. Am J Gastroenterol. 2003;98:2312–2316
  18. Lieberman DA, Weiss DG, Bond JH, Ahnen DJ, Garewal H, Chejfec G Veterans Affairs Cooperative Study Group 380. Use of colonoscopy to screen asymptomatic adults for colorectal cancer. N Engl J Med. 2000;343:162–168
  19. Imperiale TF, Wagner DR, Lin CY, Larkin GN, Rogge JD, Ransohoff DF. Results of screening colonoscopy among persons 40 to 49 years of age. N Engl J Med. 2002;346:1781–1785
  20. Brady AP, Stevenson GW, Stevenson I. Colorectal cancer overlooked at barium enema examination and colonoscopy: a continuing perceptual problem. Radiology. 1994;192:373–378
  21. Johnson CD, Carlson HC, Taylor WF, Weiland LP. Barium enemas of carcinoma of the colon: sensitivity of double- and single-contrast studies. AJR Am J Roentgenol. 1983;140:1143–1149
  22. Rex DK, Rahmani EY, Haseman JH, Lemmel GT, Kaster S, Buckley JS. Relative sensitivity of colonoscopy and barium enema for detection of colorectal cancer in clinical practice. Gastroenterology. 1997;112:17–23
  23. Kalra L, Hamlyn AN. Comparative evaluation of investigations for colorectal carcinoma in symptomatic patients. Postgrad Med J. 1988;64:666–668
  24. Irvine EJ, O'Connor J, Frost RA, et al. Prospective comparison of double contrast barium enema plus flexible sigmoidoscopy v colonoscopy in rectal bleeding: barium enema v colonoscopy in rectal bleeding. Gut. 1988;29:1188–1193
  25. Steine S, Stordahl A, Lunde OC, Loken K, Laerum E. Double-contrast barium enema versus colonoscopy in the diagnosis of neoplastic disorders: aspects of decision-making in general practice. Fam Pract. 1993;10:288–291
  26. Kewenter J, Brevinge H, Engaras B, Haglind E. The yield of flexible sigmoidoscopy and double-contrast barium enema in the diagnosis of neoplasms in the large bowel in patients with a positive Hemoccult test. Endoscopy. 1995;27:159–163
  27. Winawer SJ, Flehinger BJ, Schottenfeld D, Miller DG. Screening for colorectal cancer with fecal occult blood testing and sigmoidoscopy. J Natl Cancer Inst. 1993;85:1311–1318
  28. Toma J, Paszat LF, Gunraj N, Rabeneck L. Rates of new or missed colorectal cancer after barium enema and their risk factors: a population-based study. Am J Gastroenterol. 2008;103:3142–3148
  29. Rockey DC, Paulson E, Niedzwiecki D, et al. Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet. 2005;365:305–311
  30. Williams CB, Macrae FA, Bartram CI. A prospective study of diagnostic methods in adenoma follow-up. Endoscopy. 1982;14:74–78
  31. Winawer SJ, Stewart ET, Zauber AG, et al. National Polyp Study Work Group A comparison of colonoscopy and double-contrast barium enema for surveillance after polypectomy. N Engl J Med. 2000;342:1766–1772
  32. Kjaergard H, Nordkild P, Hennild V, Pedersen VM, Geerdsen J. Follow-up study after colorectal polypectomy (The predictive value of a negative double-contrast barium enema). Scand J Gastroenterol. 1986;21:353–356
  33. Saito Y, Slezak P, Rubio C. The diagnostic value of combining flexible sigmoidoscopy and double-contrast barium enema as a one-stage procedure. Gastrointest Radiol. 1989;14:357–359
  34. Glick S, Wagner JL, Johnson CD. Cost-effectiveness of double-contrast barium enema in screening for colorectal cancer. AJR Am J Roentgenol. 1998;170:629–636
  35. Blakeborough A, Sheridan MB, Chapman AH. Complications of barium enema examinations: a survey of UK consultant radiologists 1992 to 1994. Clin Radiol. 1997;52:142–148
  36. Ott DJ, Chen YM, Gelfand DW, Wu WC, Munitz HA. Single-contrast vs double-contrast barium enema in the detection of colonic polyps. AJR Am J Roentgenol. 1986;146:993–996
  37. Fenlon HM, Nunes DP, Schroy PC, Barish MA, Clarke PD, Ferrucci JT. A comparison of virtual and conventional colonoscopy for the detection of colorectal polyps. N Engl J Med. 1999;341:1496–1503
  38. Hara AK, Johnson CD, Reed JE, et al. Detection of colorectal polyps with CT colography: initial assessment of sensitivity and specificity. Radiology. 1997;205:59–65
  39. Kay CL, Kulling D, Hawes RH, Young JW, Cotton PB. Virtual endoscopy—comparison with colonoscopy in the detection of space-occupying lesions of the colon. Endoscopy. 2000;32:226–232
  40. Laghi A, Iannaccone R, Carbone I, et al. Detection of colorectal lesions with virtual computed tomographic colonography. Am J Surg. 2002;183:124–131
  41. McFarland EG, Pilgram TK, Brink JA, et al. CT colonography: multiobserver diagnostic performance. Radiology. 2002;225:380–390
  42. Pineau BC, Paskett ED, Chen GJ, et al. Virtual colonoscopy using oral contrast compared with colonoscopy for the detection of patients with colorectal polyps. Gastroenterology. 2003;125:304–310
  43. Yee J, Akerkar GA, Hung RK, Steinauer-Gebauer AM, Wall SD, McQuaid KR. Colorectal neoplasia: performance characteristics of CT colonography for detection in 300 patients. Radiology. 2001;219:685–692
  44. Sosna J, Morrin MM, Kruskal JB, Lavin PT, Rosen MP, Raptopoulos V. CT colonography of colorectal polyps: a metaanalysis. AJR Am J Roentgenol. 2003;181:1593–1598
  45. Ginnerup Pedersen B, Christiansen TE, Bjerregaard NC, Ljungmann K, Laurberg S. Colonoscopy and multidetector-array computed-tomographic colonography: detection rates and feasibility. Endoscopy. 2003;35:736–742
  46. Gluecker T, Dorta G, Keller W, Jornod P, Meuli R, Schnyder P. Performance of multidetector computed tomography colonography compared with conventional colonoscopy. Gut. 2002;51:207–211
  47. Iannaccone R, Laghi A, Catalano C, et al. Detection of colorectal lesions: lower-dose multi-detector row helical CT colonography compared with conventional colonoscopy. Radiology. 2003;229:775–781
  48. Macari M, Bini EJ, Xue X, et al. Colorectal neoplasms: prospective comparison of thin-section low-dose multi-detector row CT colonography and conventional colonoscopy for detection. Radiology. 2002;224:383–392
  49. Halligan S, Altman DG, Taylor SA, et al. CT colonography in the detection of colorectal polyps and cancer: systematic review, meta-analysis, and proposed minimum data set for study level reporting. Radiology. 2005;237:893–904
  50. Mulhall BP, Veerappan GR, Jackson JL. Meta-analysis: computed tomographic colonography. Ann Intern Med. 2005;142:635–650
  51. Johnson CD, Harmsen WS, Wilson LA, et al. Prospective blinded evaluation of computed tomographic colonography for screen detection of colorectal polyps. Gastroenterology. 2003;125:311–319
  52. Macari M, Bini EJ, Jacobs SL, et al. Colorectal polyps and cancers in asymptomatic average-risk patients: evaluation with CT colonography. Radiology. 2004;230:629–636
  53. Pickhardt PJ, Choi JR, Hwang I, et al. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med. 2003;349:2191–2200
  54. Cotton PB, Durkalski VL, Pineau BC, et al. Computed tomographic colonography (virtual colonoscopy): a multicenter comparison with standard colonoscopy for detection of colorectal neoplasia. JAMA. 2004;291:1713–1719
  55. Johnson CD, Chen MH, Toledano AY, et al. Accuracy of CT colonography for detection of large adenomas and cancers. N Engl J Med. 2008;359:1207–1217
  56. Regge D, Laudi C, Galatola G, et al. Diagnostic accuracy of computed tomographic colonography for the detection of advanced neoplasia in individuals at increased risk of colorectal cancer. JAMA. 2009;301:2453–2461
  57. Kim DH, Pickhardt PJ, Taylor AJ, et al. CT colonography versus colonoscopy for the detection of advanced neoplasia. N Engl J Med. 2007;357:1403–1412
  58. Pickhardt PJ, Taylor AJ, Kim DH, Reichelderfer M, Gopal DV, Pfau PR. Screening for colorectal neoplasia with CT colonography: initial experience from the 1st year of coverage by third-party payers. Radiology. 2006;241:417–425
  59. American College of Radiology. ACR practice guideline for the performance of computed tomography (CT) colonography in adults (American College of Radiology). In: Practice guidelines and technical standards. Reston, Va: American College of Radiology; 2006;p. 503–508
  60. Chin M, Mendelson R, Edwards J, Foster N, Forbes G. Computed tomographic colonography: prevalence, nature, and clinical significance of extracolonic findings in a community screening program. Am J Gastroenterol. 2005;100:2771–2776
  61. Flicker MS, Tsoukas AT, Hazra A, Dachman AH. Economic impact of extracolonic findings at computed tomographic colonography. J Comput Assist Tomogr. 2008;32:497–503
  62. Gluecker TM, Johnson CD, Wilson LA, et al. Extracolonic findings at CT colonography: evaluation of prevalence and cost in a screening population. Gastroenterology. 2003;124:911–916
  63. Pickhardt PJ, Hanson ME, Vanness DJ, et al. Unsuspected extracolonic findings at screening CT colonography: clinical and economic impact. Radiology. 2008;249:151–159
  64. Yee J, Kumar NN, Godara S, et al. Extracolonic abnormalities discovered incidentally at CT colonography in a male population. Radiology. 2005;236:519–526
  65. Macari M, Berman P, Dicker M, Milano A, Megibow AJ. Usefulness of CT colonography in patients with incomplete colonoscopy. AJR Am J Roentgenol. 1999;173:561–564
  66. Morrin MM, Kruskal JB, Farrell RJ, Goldberg SN, McGee JB, Raptopoulos V. Endoluminal CT colonography after an incomplete endoscopic colonoscopy. AJR Am J Roentgenol. 1999;172:913–918
  67. Neri E, Giusti P, Battolla L, et al. Colorectal cancer: role of CT colonography in preoperative evaluation after incomplete colonoscopy. Radiology. 2002;223:615–619
  68. Sali L, Falchini M, Bonanomi AG, et al. CT colonography after incomplete colonoscopy in subjects with positive faecal occult blood test. World J Gastroenterol. 2008;14:4499–4504
  69. Copel L, Sosna J, Kruskal JB, Raptopoulos V, Farrell RJ, Morrin MM. CT colonography in 546 patients with incomplete colonoscopy. Radiology. 2007;244:471–478
  70. Sosna J, Sella T, Sy O, et al. Critical analysis of the performance of double-contrast barium enema for detecting colorectal polyps > or = 6 mm in the era of CT colonography. AJR Am J Roentgenol. 2008;190:374–385
  71. Luboldt W, Bauerfeind P, Wildermuth S, Marincek B, Fried M, Debatin JF. Colonic masses: detection with MR colonography. Radiology. 2000;216:383–388
  72. Pappalardo G, Polettini E, Frattaroli FM, et al. Magnetic resonance colonography versus conventional colonoscopy for the detection of colonic endoluminal lesions. Gastroenterology. 2000;119:300–304
  73. Ajaj W, Pelster G, Treichel U, et al. Dark lumen magnetic resonance colonography: comparison with conventional colonoscopy for the detection of colorectal pathology. Gut. 2003;52:1738–1743
  74. Hartmann D, Bassler B, Schilling D, et al. Colorectal polyps: detection with dark-lumen MR colonography versus conventional colonoscopy. Radiology. 2006;238:143–149
  75. Lauenstein TC, Ajaj W, Kuehle CA, Goehde SC, Schlosser TW, Ruehm SG. Magnetic resonance colonography: comparison of contrast-enhanced three-dimensional vibe with two-dimensional FISP sequences: preliminary experience. Invest Radiol. 2005;40:89–96
  76. Limberg B. Diagnosis of large bowel tumours by colonic sonography. Lancet. 1990;335:144–146
  77. Chui DW, Gooding GA, McQuaid KR, Griswold V, Grendell JH. Hydrocolonic ultrasonography in the detection of colonic polyps and tumors. N Engl J Med. 1994;331:1685–1688
  78. American College of Radiology. ACR Appropriateness Criteria5: radiation dose assessment introduction. http://www.acr.org/SecondaryMainMenuCategories/quality_safety/app_criteria/RRLInformation.aspxAccessed April 23, 2010

 The ACR seeks and encourages collaboration with other organizations on the development of the ACR Appropriateness Criteria® through society representation on expert panels. Participation by representatives from collaborating societies on the expert panel does not necessarily imply society endorsement of the final document.

PII: S1546-1440(10)00259-0

doi: 10.1016/j.jacr.2010.05.005

Journal of the American College of Radiology
Volume 7, Issue 9 , Pages 670-678 , September 2010

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