AGA standards for gastroenterologists for performing and interpreting diagnostic computed tomography colonography: 2011 update

摘要

Although multiple medical professional societies, governmental agencies, and third-party payers recommend colorectal cancer (CRC) screening for adults at average or increased risk for CRC, screening rates for these populations continue to lag behind those of other malignancies. There are multiple reasons why population-wide CRC screening compliance remains "low" (near 50%55%), and chief among them is the inconvenient, invasive, and/or uncomfortable nature of commonly used screening tests such as fecal occult blood testing, flexible sigmoidoscopy, and colonoscopy. In response, CRC screening technologies are constantly being developed and evaluated. One of the newer tests, computed tomographic (CT) colonography, is an attractive option for CRC screening because of its ability to visualize the colon in a noninvasive way and because it is also relatively simple for patients to undergo. Over the past decade, experience and clinical information surrounding CRC screening and adenoma detection with CT colonography have increased dramatically. Although CT colonography was largely developed and typically performed by radiology professionals, it can also be used by gastroenterologists. As the technology surrounding CT colonography evolves, it is important that gastroenterologists not only understand the multiple issues surrounding CT colonography, but also that those who wish to perform it be able to interpret it accurately. To facilitate diffusion of knowledge pertaining to CT colonography, the American Gastroenterological Association (AGA) Institute's Governing Board convened the CT Colonography Task Force to develop training standards for gastroenterologists for CT colonography. These standards, first published in 2007, were intended to outline the basic requirements that board-certified gastroenterologists should meet to be involved in and/or perform CT colonography.1 All statements were based on the literature available at that time. Since the publication of the original standards, additional literature and regulatory decisions regarding multiple aspects of CT colonography, with implications for the performance of this diagnostic modality by gastroenterologists, have been published. This document is an update based on that new information.