Virtual colon screens equally effective for seniors as younger patients

Johnson CD. Radiology. 2012;263:1-8.

CT colonography did not detect neoplasms more effectively in patients aged younger than 65 years than it did in those aged older than 65 years, according to recent results.

Researchers conducted a post-hoc analysis of National CT Colonography Trial data involving 2,600 asymptomatic participants from 15 centers in the United States. The aim was to compare the sensitivity and specificity of CT colonography in participants aged younger than 65 years (younger group) with 497 participants aged 65 years and older (older group).

Lesions 5 mm in diameter or larger were reported by participating radiologists. The primary endpoint was the detection of histologically confirmed colorectal neoplasia of 10 mm or larger. The secondary endpoint was detection of colorectal neoplasia 6 mm to 9 mm.

The final analysis included 2,531 evaluable participants, of whom 477 were aged 65 years or older.
The prevalence of adenomas 1 cm or larger was 6.9% in the younger group and 3.7% in the older group (P<.004).

For detecting large neoplasms in the older cohort, CT colonography was linked to a sensitivity of 0.82 (95% CI, 0.644-0.944) and a specificity of 0.83 (95% CI, 0.779-0.883). For the younger cohort, CT colonography detected large neoplasms with a sensitivity of 0.92 (95% CI, 0.837-0.967) and a specificity of 0.86 (95% CI, 0.816-0.899).

Per-polyp sensitivity for large neoplasms was 0.75 (95% CI, 0.578-0.869) in the older group and 0.84 (95% CI, 0.717-0.924) in the younger group.

Per-participant sensitivity in detecting adenomas 6 mm in diameter or larger was 0.72 (95% CI, 0.565-0.854) in the older group and 0.81 (95% CI, 0.745-0.882) in the younger group.

“For most measures of diagnostic performance and in most subsets, the difference between senior-aged participants and those younger than 65 years was not statistically significant,” the researchers concluded.

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