Clinical management of small (6- to 9-mm) polyps detected at screening CT colonography: A cost-effectiveness analysis

American Journal of Roentgenology

Volumn 191, Issue 5, 2008, Pages 1509-1516

  Pickhardt, Perry J ^a,b   Hassan, Cesare ^c   Laghi, Andrea ^d   Zullo, Angelo ^c   Kim, David H ^a   Iafrate, Franco ^d   Morini, Sergio ^c  

^a UNIVERSITY OF WISCONSIN SCHOOL OF MEDICINE AND PUBLIC HEALTH   (United States)

^b UNIFORMED SERVICES UNIVERSITY OF THE HEALTH SCIENCES   (United States)

^c NUOVO REGINA MARGHERITA HOSPITAL   (Italy)

^d SAPIENZA UNIVERSITY OF ROME   (Italy)

Author keywords

Colorectal cancer; Cost effectiveness; CT colonography; Polyps; Screening; Virtual colonoscopy

Indexed keywords

ADULT; AGED; ARTICLE; CANCER GROWTH; CANCER MORTALITY; CANCER RISK; CANCER SCREENING; COLON POLYP; COLONOSCOPY; COLORECTAL CANCER; COMPUTED TOMOGRAPHIC COLONOGRAPHY; COST EFFECTIVENESS ANALYSIS; DISEASE SURVEILLANCE; ENDOSCOPIC POLYPECTOMY; FOLLOW UP; HUMAN; NEOPLASM; PATIENT REFERRAL; PERFORATION; PREVALENCE; PRIORITY JOURNAL; THEORETICAL MODEL;

AGED; AGED, 80 AND OVER; COLONOGRAPHY, COMPUTED TOMOGRAPHIC; COLORECTAL NEOPLASMS; COST-BENEFIT ANALYSIS; FEMALE; HEALTH CARE COSTS; HUMANS; INCIDENCE; INTESTINAL POLYPS; MALE; MASS SCREENING; MIDDLE AGED; RETROSPECTIVE STUDIES; SURVIVAL ANALYSIS; SURVIVAL RATE; UNITED STATES;

EID: 55549124520     PISSN: 0361803X     EISSN: None     Source Type: Journal    
DOI: 10.2214/AJR.08.1010     Document Type: Article

References (42)

1. Ries LA, Wingo PA, Miller DS, et al. The annual report to the nation on the status of cancer, 1973-1997, with a special section on colorectal cancer. Cancer 2000; 88:2398-2424
2. Morson BC. Evolution of cancer of the colon and rectum. Cancer 1974; 34:845-849
3. Levin B, Lieberman DA, McFarland B, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: joint guideline from the American Cancer Society, the U.S. Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. CA Cancer J Clin 2008; 58:130-160
4. Seeff LC, Manninen DL, Dong FB, et al. Is there endoscopic capacity to provide colorectal cancer screening to the unscreened population in the United States? Gastroenterology 2004; 127:1661-1669
5. Glass AG, Lacey JV Jr, Carreon JD, Hoover RN. Breast cancer incidence, 1980-2006: combined roles of menopausal hormone therapy, screening mammography, and estrogen receptor status. J Natl Cancer Inst 2007; 99:1152-1161
6. Pickhardt PJ, Choi JR, Hwang I, et al. Computed tomographic virtual colonoscopy to screen for colorectal neoplasia in asymptomatic adults. N Engl J Med 2003; 349:2191-2200
7. Kim DH, Pickhardt PJ, Taylor AJ, et al. CT colonography versus colonoscopy for the detection of advanced neoplasia. N Engl J Med 2007; 357:1403-1412
8. van Dam J, Cotton P, Johnson CD, et al. AGA future trends report: CT colonography. Gastroenterology 2004; 127:970-984
9. Pickhardt PJ, Hassan C, Laghi A, Zullo A, Kim DH, Morini S. Cost-effectiveness of colorectal cancer screening with CT colonography: the impact of not reporting diminutive lesions. Cancer 2007; 109:2213-2221
10. Pickhardt PJ, Hassan C, Laghi A, et al. Small and diminutive polyps detected at screening CT colonography: a decision analysis for referral to colonoscopy. AJR 2008; 190:136-144
11. Zalis ME, Barish MA, Choi JR, et al., for the Working Group on Virtual Colonoscopy. CT colonography reporting and data system: a consensus proposal. Radiology 2005; 236:3-9
12. Pickhardt PJ, Taylor AJ, Kim DH, Reichelderfer M, Gopal DV, Pfau PR. Screening for colorectal neoplasia with CT colonography: initial experience from the 1st year of coverage by third-party payers. Radiology 2006; 241:417-425
13. Hofstad B, Vatn M, Larsen S, et al. Growth of colorectal polyps: redetection and evaluation of unresected polyps for a period of three years. Gut 1996; 39:449-456
14. Knoernschild HE. Growth rate and malignant potential of colonic polyps: early results. Surg Forum 1963; 14:137-138
15. Welin S, Youker J, Spratt JS Jr, et al. The rates and patterns of growth of 375 tumors of the large intestine and rectum observed serially by double contrast enema study (Malmö technique). Am J Roentgenol Radium Ther Nucl Med 1963; 90: 673-687
16. Hur C, Chung DC, Schoen RE, Gazelle GS. The management of small polyps found by virtual colonoscopy: results of a decision analysis. Clin Gastroenterol Hepatol 2007; 5:237-244
17. Bond JH. Clinical relevance of the small colorectal polyp. Endoscopy 2001; 33:454-457
18. Pickhardt PJ, Lee AD, McFarland EG, Taylor AJ. Linear polyp measurement at CT colonography: in vitro and in vivo comparison of two-dimensional and three-dimensional displays. Radiology 2005; 236:872-878
19. Winawer SJ, Zauber AG, Fletcher RH, et al. US Multi-Society Task Force on Colorectal Cancer; American Cancer Society. Guidelines for colonoscopy surveillance after polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer and the American Cancer Society. Gastroenterology 2006; 130:1872-1885
20. Stryker SJ, Wolff BG, Culp CE, et al. Natural history of untreated colonic polyps. Gastroenterology 1987; 93:1009-1013
21. Moravec M, Lieberman DA, Holub J, Michaels L, Eisen GM. Rate of advanced pathologic features in 6-9mm polyps in patients referred for colonoscopy screening. Gastrointest Endosc 2007; 65:AB127.
22. Surveillance Epidemiology and End Results. National Cancer Institute Website. seer.cancer.gov/faststats/. Accessed April 24, 2007
23. Hassan C, Zullo A, Winn S, et al. The colorectal malignant polyp: scoping a dilemma. Dig Liver Dis 2007; 39:92-100
24. Hassan C, Zullo A, Risio M, Rossini FP, Morini S. Histologic risk factors and clinical outcome in colorectal malignant polyp: a pooled-data analysis. Dis Colon Rectum 2005; 48:1588-1596
25. Beinfeld MT, Wittenberg E, Gazelle GS. Cost-effectiveness of whole-body CT screening. Radiology 2005; 234:415-422
26. Hassan C, Pickhardt PJ, Laghi A, et al. CT colonography to screen for colorectal cancer, extracolonic cancer, and aortic aneurysm: model simulation with cost-effectiveness analysis. Arch Intern Med 2008; 168:696-705
27. Marshall D, Simpson KN, Earle CC, Chu CW. Economic decision analysis model of screening for lung cancer. Eur J Cancer 2001; 37:1759-1767
28. Mahadevia PJ, Fleisher LA, Frick KD, Eng J, Goodman SN, Powe NR. Lung cancer screening with helical computed tomography in older adult smokers. JAMA 2003; 289:313-322
29. Frazier AL, Colditz GA, Fuchs CS, Kuntz KM. Cost-effectiveness of screening for colorectal cancer in the general population. JAMA 2000; 284:1954-1961
30. Pignone M, Saha S, Hoerger T, Mandelblatt J. Cost-effectiveness analyses of colorectal cancer screening: a systematic review for the U.S. Preventive Services Task Force. Ann Intern Med 2002; 137:96-104
31. Cash BD, Kim C, Cullen P, et al. Accuracy of computed tomographic colonography for colorectal cancer screening in asymptomatic individuals. (abstr) In: Digestive Disease Week 2006 annual meeting program. Los Angeles, CA, May 20-25, 2006:473
32. Rex DK. PRO: patients with polyps smaller than 1 cm on computed tomographic colonography should be offered colonoscopy and polypectomy. Am J Gastroenterol 2005; 100: 1903-1905
33. Sprung D. Prevalence of adenocarcinoma in small adenomas. Am J Gastroenterol 2006; 101:199
34. Church JM. Clinical significance of small colorectal polyps. Dis Colon Rectum 2004; 47:481-485
35. Yoo TW, Park DI, Kim YH, et al. Clinical significance of small colorectal adenoma less than 10mm: the KASID study. Hepatogastroenterology 2007; 54:418-421
36. Vital statistics of the United States. Preprint of Volume II, Mortality; part A, section 6, Life tables. Hyattsville, MD: National Center for Health Statistics, 1998
37. Pickhardt PJ, Nugent PA, Mysliwiec PA, Choi JR, Schindler WR. Location of adenomas missed by optical colonoscopy. Ann Intern Med 2004; 141:352-359
38. Rex DK, Cutler CS, Lemmel GT, et al. Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies. Gastroenterology 1997; 112:24-28
39. Levin TR, Zhao W, Conell C, et al. Complications of colonoscopy in an integrated health care delivery system. Ann Intern Med 2006; 145:880-886
40. Anderson ML, Pasha TM, Leighton JA. Endoscopic perforation of the colon: lessons from a 10-year study. Am J Gastroenterol 2000; 95:3418-3422
41. Pickhardt PJ. Incidence of colonic perforation at CT colonography: review of existing data and implications for screening of asymptomatic adults. Radiology 2006; 239:313-316
42. Physician fee schedule look-up. Centers for Medicare & Medicaid Services Website. www.cms.hhs.gov/pfslookup. Accessed November 12, 2007