Virtual Colonoscopy CT or MRColonoscopy

Until recently, many studies on virtual colonoscopy (CT- or MR-colonoscopy) have shown different results [181-188]. The sensitivity is very low with lesions less than 1 cm and with flat lesions, while the specificity for adenoma varies from 69 to 99%.

Many technical factors could influence exam performances: bowel preparation, type of scan and the algorithm of rebuilt software. However, the lack of studies on general population, and the costs and discomfort of the technique [189] do not recommend virtual colonoscopy as a screening tool.

Normal colon cells and their DNA pass into bowel every day. Chromosomal abnormalities or DNA mutations can suggest that a colorectal polyp or cancer is present. These mutations can be detected by processing the stool. The Authors of a recent trial [190] comparing a panel of faecal DNA markers and Hemoccult II as screening tests for CRC in an average-risk, asymptomatic population conclude that the faecal DNA panel appears to be more sensitive than Hemoccult II for adenomas containing high-grade dysplasia and for the detection of early (TNM stage I, II) CRC.

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