TY - JOUR
T1 - ACR Appropriateness Criteria® Colorectal Cancer Screening
AU - Expert Panel on Gastrointestinal Imaging:
AU - Moreno, Courtney
AU - Kim, David H.
AU - Bartel, Twyla B.
AU - Cash, Brooks D.
AU - Chang, Kevin J.
AU - Feig, Barry W.
AU - Fowler, Kathryn J.
AU - Garcia, Evelyn M.
AU - Kambadakone, Avinash R.
AU - Lambert, Drew L.
AU - Levy, Angela D.
AU - Marin, Daniele
AU - Peterson, Christine M.
AU - Scheirey, Christopher D.
AU - Smith, Martin P.
AU - Weinstein, Stefanie
AU - Carucci, Laura R.
N1 - Funding Information:
Similar to colonoscopy, evidence supporting serrated polyp detection at CT is emerging. Despite a subtle, flat nature to sessile serrated polyps, these lesions can be detected at CTC likely because of a phenomenon of polyp coating. It appears that the adherent mucin elaborated by these lesions mix with the tagging agents to form a contrast coat. In an observational CTC screening study (n = 8,289), CTC demonstrated a prevalence of 3.1% for serrated lesions ≥6 mm. As seen by the colonoscopy experience, these lesions tended to be large (>10 mm), flat, and right sided. The presence of a contrast coat markedly improved lesion detection, with an odds ratio of 40.4 (95% CI, 10.1-161.4) [54].
Publisher Copyright:
© 2018 American College of Radiology
PY - 2018/5/1
Y1 - 2018/5/1
N2 - This review summarizes the relevant literature regarding colorectal screening with imaging. For individuals at average or moderate risk for colorectal cancer, CT colonography is usually appropriate for colorectal cancer screening. After positive results on a fecal occult blood test or immunohistochemical test, CT colonography is usually appropriate for colorectal cancer detection. For individuals at high risk for colorectal cancer (eg, hereditary nonpolyposis colorectal cancer, ulcerative colitis, or Crohn colitis), optical colonoscopy is preferred because of its ability to obtain biopsies to detect dysplasia. After incomplete colonoscopy, CT colonography is usually appropriate for colorectal cancer screening for individuals at average, moderate, or high risk. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
AB - This review summarizes the relevant literature regarding colorectal screening with imaging. For individuals at average or moderate risk for colorectal cancer, CT colonography is usually appropriate for colorectal cancer screening. After positive results on a fecal occult blood test or immunohistochemical test, CT colonography is usually appropriate for colorectal cancer detection. For individuals at high risk for colorectal cancer (eg, hereditary nonpolyposis colorectal cancer, ulcerative colitis, or Crohn colitis), optical colonoscopy is preferred because of its ability to obtain biopsies to detect dysplasia. After incomplete colonoscopy, CT colonography is usually appropriate for colorectal cancer screening for individuals at average, moderate, or high risk. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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U2 - 10.1016/j.jacr.2018.03.014
DO - 10.1016/j.jacr.2018.03.014
M3 - Article
C2 - 29724427
AN - SCOPUS:85046967903
VL - 15
SP - S56-S68
JO - Journal of the American College of Radiology
JF - Journal of the American College of Radiology
SN - 1558-349X
IS - 5
ER -