Date: 12 Feb 2011
Physician knowledge and appropriate utilization of computed tomographic colonography in colorectal cancer screening
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.Get Access
To assess physician understanding of computed tomographic colonography (CTC) in colorectal cancer (CRC) screening guidelines in a pilot study.
CTC is a sensitive and specific method of detecting colorectal polyps and cancer. However, several factors have limited its clinical availability, and CRC screening guidelines have issued conflicting recommendations.
A web-based survey was administered to physicians at two institutions with and without routine CTC availability.
398 of 1655 (24%) participants completed the survey, 59% was from the institution with routine CTC availability, 52% self-identified as trainees, and 15% as gastroenterologists. 78% had no personal experience with CTC. Only 12% was aware of any current CRC screening guidelines that included CTC. In a multiple regression model, gastroenterologists had greater odds of being aware of guidelines (OR 3.49, CI 1.67–7.26), as did physicians with prior CTC experience (OR 4.81, CI 2.39–9.68), controlling for institution, level of training, sex, and practice type. Based on guidelines that recommend CTC, when given a clinical scenario, 96% of physicians was unable to select the appropriate follow-up after a CTC, which was unaffected by institution.
Most physicians have limited experience with CTC and are unaware of recent recommendations concerning CTC in CRC screening.
Mulhall B, Veerappan G, Jackson J (2005) Meta-analysis: computed tomographic colonography. Ann Intern Med 142:635–650PubMed
Pickhardt P, Nugent P, Mysliwiec P, et al. (2004) Location of adenomas missed by optical colonoscopy. Ann Intern Med 141:352–359PubMed
Rockey DC, Paulson E, Niedzwiecki D, et al. (2005) Analysis of air contrast barium enema, computed tomographic colonography, and colonoscopy: prospective comparison. Lancet 365:305–311PubMed
Levin B, Lieberman D, McFarland B, et al. (2008) 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 58:130–160PubMedCrossRef
U.S. Preventive Services Task Force (2008) Screening for Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement. Ann Intern Med 149:627–637
Garg S, Ahnen DJ (2010) Is computed tomographic colonography being held to a higher standard? Ann Intern Med 152:178–181PubMed
Nadel M, Shapiro J, Klabunde C, et al. (2005) A national survey of primary care physicians’ methods for screening for fecal occult blood. Ann Intern Med 142:86–94PubMed
Mysliwiec PA, Brown ML, Klabunde CN, et al. (2004) Are physicians doing too much colonoscopy? A national survey of colorectal surveillance after polypectomy. Ann Intern Med 141:264–271PubMed
Shinners T, Pickhardt P, Taylor A, et al. (2006) Patient-controlled room air insufflation versus automated carbon dioxide delivery for CT colonography. Am J Roentgenol 186:1491–1496CrossRef
- Physician knowledge and appropriate utilization of computed tomographic colonography in colorectal cancer screening
Volume 36, Issue 5 , pp 524-531
- Cover Date
- Print ISSN
- Online ISSN
- Additional Links
- Medical education
- Colorectal cancer
- CT Colonography
- Industry Sectors
- Author Affiliations
- 1. Muzzi Mirza Pancreatic Cancer Prevention and Genetics Program, and Division of Digestive and Liver Diseases, Department of Medicine, Columbia University College of Physicians and Surgeons, 630 West 168th Street, Box 83, New York, NY, 10032, USA
- 2. Division of Digestive and Liver Diseases, Department of Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390, USA
- 3. Department of Radiology, Columbia University College of Physicians and Surgeons, 622 West 168th Street, New York, NY, USA