Hassan C, Laghi A, Pickhardt P J, Kim D H, Zullo A, Iafrate F, Morini S
Gastroenterology and Digestive Endoscopy Unit, Nuovo Regina Margherita Hospital, Rome, Italy.
Aliment Pharmacol Ther. 2008 Feb 15;27(4):366-74. doi: 10.1111/j.1365-2036.2007.03575.x. Epub 2007 Nov 13.
The impact of a primary colorectal cancer screening with computerized tomographic colonography on current radiological capacity is unknown. The multispecialty needs for computerized tomographic examinations raise some doubts on the feasibility of a mass colorectal cancer screening with computerized tomographic colonography.
To assess whether the number of available computerized tomographic units in Europe is adequate to cover population screening with computerized tomographic colonography.
A mathematical and a Markov model were, respectively, used to assess the number of computerized tomographic colonography procedures needed to be performed each day in the start-up and in the steady-state phases of a colorectal cancer screening programme in Europe. Such outcome was divided for the total number of computerized tomographic machines aged <10 years estimated to be present in the European hospitals.
At a simulated 30% compliance, 28 760 130 European people would need to be screened by the 3482 available computerized tomographic units in a 5-year start-up period, corresponding to 6.6 CTC/CT unit/day. Assuming a 10-year repetition of computerized tomographic colonography between 50 and 80 years, the number of computerized tomographic colonography needed to be performed in the steady-state period appeared to be 4.3/CT unit/day.
The current radiological capacity may cover the need for a primary colorectal cancer screening with computerized tomographic colonography in a steady state. On the other hand, a substantial implementation of the current computerized tomographic capacity or a synergistic approach with other techniques seems to be necessary for the start-up period.
计算机断层结肠成像术用于原发性结直肠癌筛查对当前放射学检查能力的影响尚不清楚。计算机断层扫描检查的多专业需求引发了对采用计算机断层结肠成像术进行大规模结直肠癌筛查可行性的一些质疑。
评估欧洲可用的计算机断层扫描设备数量是否足以满足采用计算机断层结肠成像术进行人群筛查的需求。
分别使用数学模型和马尔可夫模型来评估在欧洲结直肠癌筛查计划的启动阶段和稳态阶段每天需要进行的计算机断层结肠成像术检查数量。将此结果除以欧洲医院估计拥有的<10年的计算机断层扫描设备总数。
在模拟依从率为30%的情况下，在5年的启动期内，3482台可用的计算机断层扫描设备需要对28760130名欧洲人进行筛查，相当于每台计算机断层扫描设备每天进行6.6次计算机断层结肠成像检查。假设在50至80岁之间每10年重复进行一次计算机断层结肠成像术，稳态期需要进行的计算机断层结肠成像术数量似乎为每台计算机断层扫描设备每天4.3次。
当前的放射学检查能力在稳态下可能满足采用计算机断层结肠成像术进行原发性结直肠癌筛查的需求。另一方面，在启动阶段似乎有必要大幅增加当前的计算机断层扫描检查能力或采用与其他技术协同的方法。
