Colorectal cancer detection: time to abandon barium enema?

M K Shariff; K Sheikh; N R Carroll; S Whitley; D Greenberg; M Parkes; E A B Cameron

doi:10.1136/fg.2010.003616

Colorectal cancer detection: time to abandon barium enema?

Frontline Gastroenterol. 2011 Apr;2(2):105-109. doi: 10.1136/fg.2010.003616. Epub 2011 Jan 19.

Authors

M K Shariff¹, K Sheikh¹, N R Carroll², S Whitley², D Greenberg³, M Parkes¹, E A B Cameron¹

Affiliations

¹ Department of Gastroenterology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
² Department of Radiology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
³ Eastern Cancer Registration and Information Centre, Unit C, Hinton Way, Cambridge, UK.

Abstract

Objectives: To assess the sensitivity of double contrast barium enema (DCBE) for diagnosing colorectal cancer (CRC).

Design: Retrospective evaluation of DCBE performed in the 2 years prior to diagnosis of CRC.

Setting: Teaching hospital in Cambridge, UK.

Patients: 1310 consecutive cases of CRC identified from cancer registry data.

Interventions: DCBE and colonoscopy.

Main outcome measures: 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.