ქართული
РусскийThe role of computed tomography in colorectal cancer screening
Colorectal cancer is one of the most common cancers in the world. According to the International Agency for Research on Cancer (IARC) for 2022, it ranks third in prevalence and second in mortality. Georgia is no exception in this regard, ranking fourth among countries with a high incidence of colorectal cancer. The disease not only poses a significant threat to public health, but also requires significant financial costs for treatment and control of its complications, which makes timely diagnosis one of the priorities of modern medicine.
Most cases of colon cancer, with the exception of those caused by hereditary genetic disorders, develop from pre-existing polyps, which can undergo malignancy within 10-15 years. This means that early detection of polyps is crucial for the prevention of colorectal cancer.
Georgia has had a National screening Program since 2009, and a colorectal cancer screening program was introduced in 2010. It includes a fecal occult bleeding (FOBT) test, colonoscopic screening in case of a positive result and taking biopsy material if necessary. If the result is negative, patients can be tested for free once every two years. Unlike Georgia’s National Screening Program, computed tomography is actively used for colorectal cancer screening in the United States and some developed European countries.
Computed tomography was first used in clinical practice in the United States in 1994 and has since become widespread, especially in Europe. In Georgia, the method of computer colonography was introduced at the Batumi Referral Hospital in 2015 and is gaining popularity every year.
The European Society of Gastrointestinal Endoscopy (ESGE) and the European Society of Gastrointestinal and Abdominal Radiology (ESGAR) recommend computed colonography as the least invasive and highly informative method of diagnosing colorectal neoplasms, which can detect cancer at an early stage. Computed colonography has high sensitivity and specificity, allowing not only to detect cancer and its precursors — polyps — in asymptomatic patients, but also to assess the lumen, wall thickness and structure of the colon, as well as to identify pathological changes, determine the exact location of the tumor, the degree of its invasion, the condition of surrounding tissues and lymph nodes, the presence of regional and distant metastases. Additionally, this method allows you to assess the condition of other abdominal organs.
However, computer-aided colonography has not yet become widespread throughout Georgia. Given the low percentage of early detection of colorectal cancer (4.1%) and the positive experience of other countries, it is advisable to include computed colonography in the colorectal cancer screening program if there are certain indications. This method is especially effective for detecting hidden polyps, the removal of which by endoscopy reduces the risk of colorectal cancer and the mortality rate from this disease.
Thus, the main purpose of screening computed colonography is to identify hidden neoplasms, such as polyps, to prevent their malignancy and reduce the risk of colorectal cancer.