A systematic review 1 including 33 studies with a total of 6393 subjects was abstracted in DARE. Overall, the sensitivity for CT colonography was 70% (95% CI: 53 to 87). Sensitivity increased as polyp size increased: sensitivity was 48% (95% CI: 25 to 70) for polyps smaller than 6 mm, 70% (95% CI: 55 to 84) for polyps between 6 and 9 mm, and 85% (95% CI: 79 to 91) for polyps larger than 9 mm. There was evidence of statistical heterogeneity for each analysis (P<0.001). The specificity for CT colonography was 86% (95% CI: 84 to 88). The specificity was 91% (95% CI: 89 to 95) for polyps smaller than 6 mm, 93% (95% CI: 91 to 95) for polyps between 6 and 9 mm, and 97% (95% CI: 96 to 97) for polyps larger than 9 mm.
Comment: Heterogeneity in the reported sensitivities raises concerns about the consistency of performance and technical variability. The authors state that CT colonography needs further refinement before it can be recommended for general use in screening for colorectal cancer.
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