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Colorectal cancer detection: time to abandon barium enema? 2011

M K Shariff, and K Sheikh, and N R Carroll, and S Whitley, and D Greenberg, and M Parkes, and E A B Cameron
Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

OBJECTIVE To assess the sensitivity of double contrast barium enema (DCBE) for diagnosing colorectal cancer (CRC). METHODS Retrospective evaluation of DCBE performed in the 2 years prior to diagnosis of CRC. METHODS Teaching hospital in Cambridge, UK. METHODS 1310 consecutive cases of CRC identified from cancer registry data. METHODS DCBE and colonoscopy. METHODS Sensitivity of DCBE for diagnosing CRC. RESULTS 215 patients had undergone a DCBE within the 2 years prior to diagnosis with CRC. After excluding those reported as inadequate, 37 of these were reported as normal, giving a sensitivity of 83% (81-85%). CONCLUSIONS The performance of DCBE is inadequate for the exclusion of CRC. Expansion of colonoscopy and CT colonography capacity is urgently required nationally so that DCBE can finally be abandoned as a firstline test in patients at risk of CRC.

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