Utilization of Computed Tomography Colonography (CTC) at a District General Hospital: A Retrospective Analysis

TL;DR

This study examines the low use of CTC for colorectal cancer screening in a UK hospital, highlighting barriers like limited resources and training.

Contribution

The study identifies DGH-specific barriers to CTC adoption and emphasizes the need for policy changes to improve access.

Findings

CTC was used as a first-line investigation in only 3.5% of cases at the DGH.

Limited radiologist training and CT scanner capacity hinder CTC adoption.

Institutional preference for colonoscopy contributes to low CTC utilization.

Abstract

Colorectal cancer (CRC) is one of the most common cancers worldwide, necessitating efficient diagnostic pathways. While colonoscopy remains the gold standard, computed tomography colonography (CTC) offers a non-invasive alternative, particularly for elderly and comorbid patients. This retrospective study, conducted at a UK district general hospital (DGH), evaluated patterns of CTC utilization among patients referred for colonic investigations over a 12-month period. Despite CTC’s high diagnostic accuracy (93% sensitivity for polyps > 10 mm) and its suitability for high-risk populations, it was used as a first-line investigation in only 3.5% of cases, markedly lower than the 12%-15% reported in tertiary centers. Contributing factors included limited radiologist training, restricted CT scanner capacity, and a prevailing institutional preference for colonoscopy. Addressing these DGH-specific barriers, such as resource constraints and workforce limitations, is critical to enhancing CTC’s role within the two-week-wait (2WW) pathway. This study underscores the need for multicenter research to validate these findings and guide policy development, ensuring equitable access to non-invasive diagnostics for frail, comorbid, or preference-driven populations.

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