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Age, sex predict advanced neoplasia in screening CT colonography
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Increasing age and male sex were associated with increases in advanced neoplasia risk in a cohort of patients who underwent CT colonography, according to study results.
Researchers from several sites in Italy and the United States conducted the investigation to determine the effect of age, sex, BMI and a positive family history of colorectal cancer on advanced neoplasia risk when screening with CT colonography is used.
The cohort included 7,620 patients.
Patients who received a first CT colonography from 2004 to 2011 at a single site were eligible for analysis. Researchers recorded pathology results for all patients who underwent polypectomy.
Advanced neoplasia occurred in 3.6% of patients (95% CI, 3.2-4.1).
Multivariable analysis results indicated that for each 10-year increase in age, the mean OR for advanced neoplasia was 1.8 (95% CI, 1.6-2.0). Male sex also predicted advanced neoplasia (OR=1.7; 95% CI, 1.3-2.2).
BMI and a positive family history of colorectal cancer failed to predict the development of advanced neoplasia.
There was a range in the number of screenings required to detect one case of advanced neoplasia. Fifty-one screenings were required to detect one case among women aged 55 years or younger, whereas 10 screenings were required to detect one case among men aged older than 65 years.
Two to four post-CT colonography colonoscopies were required to detect one case of advanced neoplasia.
“We showed that the possibility for average-risk individuals to have clinically meaningful polyps detected by virtual colonoscopy is strictly associated with two main variables, namely age and sex,” study researcher Cesare Hassan, MD, of the department of gastroenterology at ONRM Hospital in Rome, said in a press release. “If you are a man, the best age to have a virtual colonoscopy is between 55 and 60 years, but if you are a woman, you can at least wait until 60 years.”
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