Carcinoma of the colon and rectum. Tumors missed by radiologic examination in 61 patients

Cancer. 1988 May 15;61(10):1999-2008. doi: 10.1002/1097-0142(19880515)61:10<1999::aid-cncr2820611012>3.0.co;2-w.

Abstract

Radiologic examinations preceding the diagnosis of colorectal carcinomas were retrospectively scrutinized in 708 patients with 731 carcinomas that were radiographically investigated 741 times. Sixty-four lesions were missed 74 times, giving a 90% sensitivity of the radiographic methods used. Of the errors, 82% were perceptive, and 3% were interpretative. Eleven examinations in nine patients revealed no lesions, although the examinations were done within 2 years of the diagnosis of a carcinoma. Missed lesions were more common than expected in the cecum and the ascending colon (P less than 0.001), and 18% of the patients had multiple tumors (expected incidence 3.6%, P less than 0.001). The median delay in diagnosis was 20 months, and patients whose diagnosis was delayed for a long time tended to have more advanced carcinomas at diagnosis. As a lesion was identified either at the initial examination or retrospectively 730 of 741 times, the potential sensitivity of the radiographic methods used was 99%. It is concluded that barium enema is still an excellent method for the detection of colorectal carcinoma provided that perceptive errors can be minimized.

MeSH terms

  • Barium Sulfate*
  • Carcinoma / diagnostic imaging*
  • Colonic Neoplasms / diagnostic imaging*
  • Colonic Polyps / diagnostic imaging
  • Colonoscopy
  • Diagnostic Errors*
  • Enema
  • False Negative Reactions
  • Humans
  • Neoplasms, Multiple Primary / diagnostic imaging
  • Radiography
  • Rectal Neoplasms / diagnostic imaging*
  • Retrospective Studies

Substances

  • Barium Sulfate