Imperial College London
Mr Omar Faiz

MrOmarFaiz

Faculty of Medicine, Department of Surgery & Cancer

Professor of Practice (Colorectal Surgery)
 
 
 
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Contact

 

o.faiz

 
 
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Location

 

Queen Elizabeth the Queen Mother Wing (QEQM)St Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Halligan:2013,
author = {Halligan, S and Wooldrage, K and Dadswell, E and Kralj-Hans, I and Von, Wagner C and Edwards, R and Yao, G and Kay, C and Burling, D and Faiz, O and Teare, J and Lilford, RJ and Morton, D and Wardle, J and Atkin, W and For, the SIGGAR Investigators},
journal = {Lancet},
pages = {1185--1193},
title = {Computed tomographic colonography versus barium enema for diagnosis of colorectal cancer or large polyps in symptomatic patients (SIGGAR): a multicentre randomised trial.},
volume = {381},
year = {2013}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BACKGROUND: Barium enema (BE) is widely available for diagnosis of colorectal cancer despite concerns about its accuracy and acceptability. Computed tomographic colonography (CTC) might be a more sensitive and acceptable alternative. We aimed to compare CTC and BE for diagnosis of colorectal cancer or large polyps in symptomatic patients in clinical practice.METHODS: This pragmatic multicentre randomised trial recruited patients with symptoms suggestive of colorectal cancer from 21 UK hospitals. Eligible patients were aged 55 years or older and regarded by their referring clinician as suitable for radiological investigation of the colon. Patients were randomly assigned (2:1) to BE or CTC by computer-generated random numbers, in blocks of six, stratified by trial centre and sex. We analysed the primary outcome-diagnosis of colorectal cancer or large (≥10 mm) polyps-by intention to treat. The trial is an International Standard Randomised Controlled Trial, number 95152621.FINDINGS: 3838 patients were randomly assigned to receive either BE (n=2553) or CTC (n=1285). 34 patients withdrew consent, leaving for analysis 2527 assigned to BE and 1277 assigned to CTC. The detection rate of colorectal cancer or large polyps was significantly higher in patients assigned to CTC than in those assigned to BE (93 [7·3%] of 1277 vs 141 [5·6%] of 2527, relative risk 1·31, 95% CI 1·01-1·68; p=0·0390). CTC missed three of 45 colorectal cancers and BE missed 12 of 85. The rate of additional colonic investigation was higher after CTC than after BE (283 [23·5%] of 1206 CTC patients had additional investigation vs 422 [18·3%] of 2300 BE patients; p=0·0003), due mainly to a higher polyp detection rate. Serious adverse events were rare.INTERPRETATION: CTC is a more sensitive test than BE. Our results suggest that CTC should be the preferred radiological test for patients with symptoms suggestive of colorectal cancer.FUNDING: NIH
AU  - Halligan,S
AU  - Wooldrage,K
AU  - Dadswell,E
AU  - Kralj-Hans,I
AU  - Von,Wagner C
AU  - Edwards,R
AU  - Yao,G
AU  - Kay,C
AU  - Burling,D
AU  - Faiz,O
AU  - Teare,J
AU  - Lilford,RJ
AU  - Morton,D
AU  - Wardle,J
AU  - Atkin,W
AU  - For,the SIGGAR Investigators
EP  - 1193
PY  - 2013///
SP  - 1185
TI  - Computed tomographic colonography versus barium enema for diagnosis of colorectal cancer or large polyps in symptomatic patients (SIGGAR): a multicentre randomised trial.
T2  - Lancet
VL  - 381
ER  -
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