Abstract
The incidence of colorectal cancer (CRC) has been increasing in Asian countries including Thailand. Double contrast barium enema (DCBE) is one of the investigation tools used in CRC screening. This study aimed to determine the incidence of colorectal neoplasm detected at screening by DCBE in Thai people. The computerized radiology database of screening DCBE in Thai adults between June 2009 and October 2011 at the Faculty of Medicine, Siriraj Hospital, was reviewed. DCBE examination performed in a surveillance program after curative CRC resection or the removal of colorectal polyps was also considered as a screening DCBE. A total of 819 screening DCBEs performed during this 28-month period were analyzed. The mean age of patients was 59.8 ∓ 13.6 years. Of the total, 467 (57%) were male. A family history of CRC and a previous history of curative CRC resection or polyp removal were noted in 34 patients (4%) and 124 patients (15%), respectively. A total of 31 patients (3.8%; 95%CI = 2.7%-5.3%) were reported to have colorectal polyp or mass demonstrated on DCBE. Of these, follow-up endoscopy was performed in 20 cases (65%). According to pathological results, the incidence of advanced adenoma and CRC detected at screening DCBE was 0.7% (95%CI = 0.3%-1.6%; n=6) and 0.4% (95%CI = 0.1%-1.1%; n=3), respectively. The screening DCBE performed in Thai adults had a diagnostic yield of 0.7% for advanced adenoma and 0.4% for CRC.
Highlights
Colorectal cancer (CRC) is the leading cause of cancer-related death worldwide
In 2008, the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology released a comprehensive guideline for screening and surveillance for the early detection of colorectal cancer (CRC) and adenomatous polyps (Levin et al, 2008)
In this update recommendation for CRC screening, Double contrast barium enema (DCBE) was classified as a screening tool that identifies cancer early and and detects colorectal adenomas
Summary
Colorectal cancer (CRC) is the leading cause of cancer-related death worldwide. The current international practice guidelines and expert consensus statements recommend CRC screening for average-risk people start at the age of 50 years using various screening tools (Levin et al, 2008; Sung et al, 2008; Segnan et al, 2010). Among these tools, double contrast barium enema (DCBE) is a non-invasive investigation which provides a complete colonic evaluation.
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