A study looking at colonoscopies and CT scans for people with symptoms of bowel cancer
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This study was for people who had symptoms that could be caused by bowel cancer. Everyone taking part had been asked by their doctor to have a test to look for the cause of their bowel symptoms.
It was for people going to Guy’s and St Thomas’ Hospital in London.
The study was open for people to join between 2016 and 2018. The team published the results in 2020.
More about this trial
Possible symptoms of bowel cancer include:
- blood in your poo (stools)
- constipation or a change in your normal bowel habit
- a lump in your back passage or tummy (abdomen)
For symptoms of bowel cancer you usually have a test that looks at the inside of the bowel (a colonoscopy). A colonoscopy can help to find the cause of the bowel symptoms and look for early signs of bowel cancer.
But colonoscopies can cause some problems such as bleeding and a small tear (perforation) in the bowel. Colonoscopies are also expensive.
Another possible test is a type of CT scan called CT colonography. A CT scan uses x-rays to take detailed pictures of your body from different angles. They are safe and easy to have.
Doctors wanted to look at using CT colonography to take detailed pictures of the large bowel (colon) and back passage (rectum). This test can help to find out the cause of bowel symptoms.
Everyone taking part had either a colonoscopy or a CT colonography. This was agreed by their doctor. It was based on the preference of the person taking part and if they could have the test.
The main aims of this trial were to find out:
- whether a CT colonography is as good as a colonoscopy as a first test to look for the cause of bowel symptoms
- the cost of using a CT colonography to test for bowel cancer when compared to a colonoscopy
- how the people taking part felt about having each test
Summary of results
This study showed that CT colonography could be used as a first test to look for the cause of bowel symptoms.
180 people joined the study. Everyone taking part had symptoms and a low to intermediate 
of developing bowel cancer. Not everyone decided to, or were able to, have a test:
- 109 people had a colonoscopy
- 68 people had CT colonography
The researchers looked at the average financial cost to the NHS for people having either test. At 6 months the average cost was:
- £991 for each person in the colonoscopy group
- £645 for each person in the CT colonography group
This showed that having a CT colonography saved the NHS money when compared to having a colonoscopy.
The researchers were able to look at the results of tests for:
- 105 people who had a colonoscopy
- 68 people who had a CT colonography test
5 people were diagnosed with cancer in the colonoscopy group. And 6 people were diagnosed with cancer in the CT colonography group.
The people taking part were asked about how they felt:
- about the
bowel preparation (before the test) - about the test itself
- the morning after the test
There was no difference between the two groups in how they felt before, during and after the test. Most people found the test itself as they expected or better than they expected.
The researchers did not look at the side effects of having the tests.
Conclusion
CT colonography improved access to tests for people waiting for investigations. It is cheaper than having a colonoscopy. And it meant that people who needed a colonoscopy, rather than a scan, were able to access one more easily.
More detailed information
There is more information about this research in the reference below.
Please note, the information we link to here is not in plain English. It has been written for healthcare professionals and researchers.
An observational study to compare the utilisation of computed tomography colonography with optical colonoscopy as the first diagnostic imaging tool in patients with suspected colorectal cancer
T Rua and others
Clinical Radiology, 2020. Volume 75, issue 9, page 712.
Where this information comes from
We have based this summary on the information in the article above. This has been reviewed by independent specialists () and published in a medical journal. We have not analysed the data ourselves. As far as we are aware, the link we list above is active and the article is free and available to view.
Recruitment start:
Recruitment end:
How to join a clinical trial
Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.
Chief Investigator
Dr Nyree Griffin
Supported by
Guy’s and St Thomas’ NHS Foundation Trust
Guy’s and St Thomas’ Charity
Kings College London
Transforming Outcomes and Health Economics through Imaging (TOHETI)
If you have questions about the trial please contact our cancer information nurses
Freephone 0808 800 4040
