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Bowel Cancer Screening

Bowel Cancer Screening. Radiology 2011 Dr. FW Poon. Investigation algorithm. Colonoscopy. Incomplete examination. Complete colonoscopy but abnormal finding. Normal colonoscopy. Additional Imaging BE or CTC. No further action. Symptomatic route. Date of Radiology offered

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Bowel Cancer Screening

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  1. Bowel Cancer Screening Radiology 2011 Dr. FW Poon

  2. Investigation algorithm Colonoscopy Incomplete examination Complete colonoscopy but abnormal finding Normal colonoscopy Additional Imaging BE or CTC No further action Symptomatic route

  3. Date of Radiology offered within 3 weeks Radiology report on CRIS Report Screening IT system Print report to endoscopist Normal Abnormal Further appropriate assessment and Investigations by endoscopist Patient/GP

  4. Total number of colonoscopy For the calendar year 2009 - 1079 • - 2008 Most patients did not need additional radiology In 2010, 47 (2.3%) had additional radiology for failed colonoscopy

  5. Radiology 07/09-12/09 01/10-06/10 07/10-12/10 31 28 19 16 15 7 21 8 11 BE -1 polyp & -1 benign stricture CTC -3 polyps Others : GS, AAA, Bladder cancer, mysenteric cyst BE -1 ? Benign stricture • CTC • 4 cancers • 3 polyps • 1 ? benign • Stricture • Others: AAA, lipoma, BE -1 polyp CTC -2 polyps Others: Renal stones, GS, HH,pneumonia

  6. In WOS, the overall trend is to perform more CTC instead of BE • What is CTC • What is BE • Why CTC better?

  7. Comparing BE vs CTC • 2-D imaging • Can only visualise mucosal abnormality • Overlapping structures make interpretation difficult • lower sensitivity and specificity than CTC

  8. What is CTC ?

  9. Polyp

  10. CT Colonoscopy

  11. BE vs CTC BMJ 2007; 335:715-8

  12. CTC less discomfort compared BE and optical colonoscopy

  13. Bowel cancer screening • With the support of GGC Trust, an enormous effect has been made to make CTC more widely available • More fast CT scanners and more trained radiologists are now available to support the programme

  14. Bowel cancer screening The most important fact is to have your screening done

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