ESGAR 2022 Book of Abstracts

Purpose: Colonoscopy is the gold standard investigation for colorectal cancer but CT colonography (CTC) is used for those unable to tolerate.We aim to investigate the appropriateness of CTC referrals in a large district teaching hospital and how the CTC findings and patient management correlate.Material and Methods: Retrospective audit and re-audit cycle looking at all the CTCs performed in patients aged 80 or above in a 6-month period (2019) was conducted.Consequently, a new referral pathway was implemented in which patients aged 85 or above were excluded from having a CTC unless exceptional circumstances.Indications for the CTC were also analysed as well as the average reporting time.Results: 250 CTCs were performed in patients aged 80 or above.18 (7%) had polyps.13 were treated (72%) and the 5 (28%) not treated were 82 or older.The second cycle showed decreased number of CTCs, averaging 23/month (compared to 130/month) with only 6% of CTC in patients 85 or above.Higher percentage of positive patients were treated compared to before.Reduced reporting times were also achieved. Conclusion:Although CTC allows other incidental assessment, it does not allow suspicious lesions to be biopsied and requires the patient to be mobile and competent.These factors among others are often not appreciated by the referrers; therefore, integrating an age limit with patient health status is suggested as part of the CTC referral pathway to reduce inappropriate CTC referrals.Performing sigmoidoscopy and a staging CT in the first line is also a suggestion if the patient cannot tolerate complete colonoscopy.