2021 Volume 36 Issue 1 Pages 7-18
CT colonography (CTC) shows the same accuracy for detecting colorectal tumors as colonoscopy, and the quality of CTC examinations is not affected by radiographer skill or experience. The procedure is minimally invasive and safe, and thus, CTC is suitable for colorectal cancer screening. CT is expected to be a detailed evaluation method for patients with positive fecal immunochemical test results and is also useful for primary screening during comprehensive medical examinations.
Japan has the largest number of CT instruments worldwide. In Japan, the use of automatic carbon dioxide insufflation equipment received regulatory approval in 2011, and CTC has been covered by insurance since 2012; a CTC-dedicated barium contrast agent was approved as a pharmaceutical and medical device in 2016. These factors have resulted in widespread CTC use. Although the infrastructure has improved, issues such as variability in bowel preparation and availability of radiologists need to be considered. The number of deaths from colorectal cancer in Japan is increasing, and therefore, it is important to improve screening and close examination rates to reduce colorectal cancer mortality.
Highly receptive and safe CTC is expected to represent a means of improving the sluggish screening and close examination rates. To reduce colorectal cancer mortality, it is important to efficiently incorporate CTC in colorectal cancer screening, which has been mainly performed using the fecal occult blood test, and build an effective and systematic screening system.
