Jsj. Gillespie et Be. Kelly, Double contrast barium enema and colorectal carcinoma: sensitivity and potential role in screening, ULSTER MED, 70(1), 2001, pp. 15-18
To establish the sensitivity of double contrast barium enema (DCBE) for det
ection of colorectal carcinoma in a tertiary referral centre and consider i
ts possible role as a suitable imaging method in screening for this disease
.
A total of 160 patients with a histopathologically proven diagnosis of colo
rectal carcinoma over a two year period were reviewed. Subsequently 112 of
the 160 patients were identified as having undergone DCBE, the results of w
hich were analysed to determine its sensitivity for detecting colorectal ca
rcinoma.
Colorectal carcinoma was missed in 4 of the 112 barium enemas performed. Th
is corresponds to a sensitivity of 96.5% with a false negative rate of 3.5%
. The Dukes Classification in these 4 cases showed that Dukes stage B, C an
d D were missed, with tumours located in the right and the sigmoid colon. T
he mean delay to operation in these four cases was 6 weeks. Our study corre
lates with previous studies showing a false negative rate for DCBE of 3.5%,
Colonoscopy also fails to detect small numbers of tumours with false negat
ive rates reported as high as 10%. We suggest that double contrast: barium
enema should be effective as a screening method in any future colorectal ca
ncer screening program.