A Comparison between Colonoscopy and Computed Tomography Colonography in Detection of Colorectal Neoplasia رسالة ماجستير

Abstract

Introduction Colorectal cancer (CRC) is the third most diagnosed cancer and cause of cancer-related deaths in the USA, particularly affecting men under 50. In Palestine, CRC is the second most common cancer, with a rising incidence rate. Colonic polyps, which can lead to CRC, are categorized as neoplastic or non-neoplastic, with adenomas potentially becoming malignant. Early detection through screening like colonoscopy (CS) is vital for preventing CRC. Computed tomography colonography (CTC), a less invasive alternative to CS, provides similar accuracy but requires proper preparation for effective screening, with a sensitivity comparable to CS for detecting colorectal abnormalities. Purpose The study aims to assess the effectiveness of CT colonography (CTC) compared to optical colonoscopy (OC) in detecting colorectal neoplasia in Palestinian hospitals and to improve diagnostic methods. Methods The study retrospective cross-sectional quantitative analysis aimed to compare the sensitivity of CTC with optical colonoscopy (OC) for detecting colorectal neoplasia in patients. The study analyzed 68 patients using retrospective data (2019-2024) from four hospitals at An-Najah National Hospital, Martyr Khalil Suleiman Hospital, Iben Sina Specialized Hospital, and Al-Razi Hospital. Participants had colorectal polyps or cancer and underwent CTC under suboptimal preparation. Statistical analysis compared CTC and OC sensitivities. Results CTC detected 78.6% of masses but failed to detect any polyps, with a weak agreement (Cohen's κ = 0.235) between CTC and OC. Sensitivity for colorectal neoplasia detection was only 36.3%, with a high error rate of 63.7%. V Conclusion CTC demonstrated moderate sensitivity for mass detection but was ineffective in identifying polyps. These findings highlight the need for adherence to international protocols to improve the accuracy of CTC for comprehensive colorectal screening