The Benefits of Computed Tomographic Colonography in Reducing a Long Colonoscopy Waiting List

Abstract Purpose The Radiology Department, Royal Jubilee Hospital, Victoria, BC, with the support of gastroenterologists and surgeons, was awarded a BC Innovation fund to run a pilot project of computed tomographic colonography to reduce an unacceptably long 2-year colonoscopy waiting list. Funds we...

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Veröffentlicht in:Canadian Association of Radiologists journal 2010-02, Vol.61 (1), p.33-40
Hauptverfasser: Behrens, Carola, MASc, Stevenson, Giles, FRCPC, Eddy, Richard, FRCPC, Pearson, David, FRCPC, Hayashi, Allen, FRCSC, Audet, Louise, MRT, Mathieson, John, FRCPC
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container_end_page 40
container_issue 1
container_start_page 33
container_title Canadian Association of Radiologists journal
container_volume 61
creator Behrens, Carola, MASc
Stevenson, Giles, FRCPC
Eddy, Richard, FRCPC
Pearson, David, FRCPC
Hayashi, Allen, FRCSC
Audet, Louise, MRT
Mathieson, John, FRCPC
description Abstract Purpose The Radiology Department, Royal Jubilee Hospital, Victoria, BC, with the support of gastroenterologists and surgeons, was awarded a BC Innovation fund to run a pilot project of computed tomographic colonography to reduce an unacceptably long 2-year colonoscopy waiting list. Funds were approved in April 2007 for a 1-year project, which was completed on March 31, 2008. Methods This article describes the challenges of delivering a high-volume computed tomographic colonography program at a busy community hospital, with discussion of the results for the 2,005 patients who were examined. Results Colonoscopy was avoided in 1,462 patients whose computed tomographic studies showed no significant lesions. In the remainder of patients, only lesions larger than 5 mm were reported, with a total of 508 lesions identified in 433 patients. There were 57 cancers of which 52 were reported as either definite or possible cancers, whereas 5 were not seen on initial scans. Some of the patients with cancer had been on the colonoscopy waiting list for 2 years. In addition, there were 461 patients with significant extracolonic findings, including 84 who required urgent or semi-urgent further management for previously unsuspected conditions, such as pneumonia, aneurysms larger than 5 cm, and a range of solid renal, hepatic, and pancreatic masses. There were no procedural complications from the computed tomographic colon studies. Conclusions We have shown that it is feasible to run a high volume CTC service in a general hospital given hospital support and funding. The benefits in this group of over 2000 patients included avoidance of colonoscopy in over 70% of patients, detection of significant polyps or cancer in approximately 20% of patients, and identification of clinically important conditions in 7%–18% depending on the definition used. The estimated costs including capital, operating, and professional fees were in the range of $400.
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Funds were approved in April 2007 for a 1-year project, which was completed on March 31, 2008. Methods This article describes the challenges of delivering a high-volume computed tomographic colonography program at a busy community hospital, with discussion of the results for the 2,005 patients who were examined. Results Colonoscopy was avoided in 1,462 patients whose computed tomographic studies showed no significant lesions. In the remainder of patients, only lesions larger than 5 mm were reported, with a total of 508 lesions identified in 433 patients. There were 57 cancers of which 52 were reported as either definite or possible cancers, whereas 5 were not seen on initial scans. Some of the patients with cancer had been on the colonoscopy waiting list for 2 years. In addition, there were 461 patients with significant extracolonic findings, including 84 who required urgent or semi-urgent further management for previously unsuspected conditions, such as pneumonia, aneurysms larger than 5 cm, and a range of solid renal, hepatic, and pancreatic masses. There were no procedural complications from the computed tomographic colon studies. Conclusions We have shown that it is feasible to run a high volume CTC service in a general hospital given hospital support and funding. The benefits in this group of over 2000 patients included avoidance of colonoscopy in over 70% of patients, detection of significant polyps or cancer in approximately 20% of patients, and identification of clinically important conditions in 7%–18% depending on the definition used. The estimated costs including capital, operating, and professional fees were in the range of $400.</description><identifier>ISSN: 0846-5371</identifier><identifier>EISSN: 1488-2361</identifier><identifier>DOI: 10.1016/j.carj.2009.09.003</identifier><identifier>PMID: 20004547</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Butylscopolammonium Bromide ; Colon cancer ; Colonic Neoplasms - diagnosis ; Colonography, Computed Tomographic - methods ; Colonography, Computed Tomographic - statistics &amp; numerical data ; Colonoscopy ; Colonoscopy - statistics &amp; numerical data ; Colorectal cancer ; CT colonography ; Education, Medical, Continuing ; Female ; Hospitals, Community ; Humans ; Male ; Middle Aged ; Parasympatholytics ; Pilot Projects ; Polyp ; Radiology ; Radiology - education ; Studies ; Tomography ; Victoria ; Waiting Lists</subject><ispartof>Canadian Association of Radiologists journal, 2010-02, Vol.61 (1), p.33-40</ispartof><rights>Canadian Association of Radiologists</rights><rights>2010 Canadian Association of Radiologists</rights><rights>2010 Canadian Association of Radiologists. Published by Elsevier Inc. 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Funds were approved in April 2007 for a 1-year project, which was completed on March 31, 2008. Methods This article describes the challenges of delivering a high-volume computed tomographic colonography program at a busy community hospital, with discussion of the results for the 2,005 patients who were examined. Results Colonoscopy was avoided in 1,462 patients whose computed tomographic studies showed no significant lesions. In the remainder of patients, only lesions larger than 5 mm were reported, with a total of 508 lesions identified in 433 patients. There were 57 cancers of which 52 were reported as either definite or possible cancers, whereas 5 were not seen on initial scans. Some of the patients with cancer had been on the colonoscopy waiting list for 2 years. 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Funds were approved in April 2007 for a 1-year project, which was completed on March 31, 2008. Methods This article describes the challenges of delivering a high-volume computed tomographic colonography program at a busy community hospital, with discussion of the results for the 2,005 patients who were examined. Results Colonoscopy was avoided in 1,462 patients whose computed tomographic studies showed no significant lesions. In the remainder of patients, only lesions larger than 5 mm were reported, with a total of 508 lesions identified in 433 patients. There were 57 cancers of which 52 were reported as either definite or possible cancers, whereas 5 were not seen on initial scans. Some of the patients with cancer had been on the colonoscopy waiting list for 2 years. 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subjects Adult
Aged
Aged, 80 and over
Butylscopolammonium Bromide
Colon cancer
Colonic Neoplasms - diagnosis
Colonography, Computed Tomographic - methods
Colonography, Computed Tomographic - statistics & numerical data
Colonoscopy
Colonoscopy - statistics & numerical data
Colorectal cancer
CT colonography
Education, Medical, Continuing
Female
Hospitals, Community
Humans
Male
Middle Aged
Parasympatholytics
Pilot Projects
Polyp
Radiology
Radiology - education
Studies
Tomography
Victoria
Waiting Lists
title The Benefits of Computed Tomographic Colonography in Reducing a Long Colonoscopy Waiting List
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