SRS360 - Comparative study between the performance of computed tomography colonography (CTC) and the gold standard colonoscopy in the patients with positive faecal immunochemical test (FIT) values on the colorectal cancer pathway in an NHS district general hospital (a retrospective 4-year study)

Abstract Aim Assessing the performance of CTC in comparison to Colonoscopy on a large sample size of patients (10 024) aiming to find out if CTC is a reliable alternative initial test for the patients who test positive for FIT in the last four years Methods Data collected from The DGH Cancer Performance Team, The Cancer Register, The Radiology department and The Internal Hospital System for all the DGH GP referrals of the Patients who had FIT tests and on the Colorectal Cancer Pathway excluding all the referrals of the Iron Deficiency Patients Results The sample size of 10 024 patients in the last four years was analysed and 7% out of them were diagnosed with colorectal cancer, 4696 Colonoscopies were performed while only 993 CTCs were performed and the rest of the sample size were investigated by other methods as MRI , or CT TAP. 85% of the Patients diagnosed with Colorectal Cancer was confirmed by Colonoscopy only. While 11% of the Cancer patients was confirmed by CTC only. However, 5% of the Cancer patients had Colonoscopy as a Completion after CTC which was non-conclusive. Conclusions CTC is used as an initial step in the current practice in patients on the colorectal cancer pathway who are not fit for colonoscopy and also patients who decline colonoscopy. After analysis of the results, CTC is a good alternative in detection of Colorectal Cancer yet it has its own limitations; However Colonoscopy remains the gold standard initial reliable investigation in the patients on Colorectal Cancer Pathway.