Accuracy of roentgenologic examination in detecting carcinoma of the colon

Abstract

Summary A study was undertaken to determine the accuracy of the barium-enema examination in detecting carcinoma of the colon. It was divided into two parts, one to determine the accuracy of barium-enema examinations in proved cases of carcinoma of the colon and the second to determine the likelihood of false-positive reports of carcinoma based on such examinations. Of 707 cases in which lesions histologically proved to be carcinoma of the colon were located above the region of proctoscopic visualization, the lesion was either missed or misdiagnosed in 49 cases — an over-all diagnostic error of 6.9 per cent. If one excludes those carcinomas that were found but misinterpreted, those associated with chronic ulcerative colitis, and those recurring at anastomoses, the diagnostic accuracy in this series was 95.9 per cent. Of 577 cases in which a roentgenologic diagnosis of carcinoma of the colon was made, false-positive diagnoses were made in five cases—an error of 0.87 per cent. The difficulties in detecting carcinoma of the colon by means of the barium-enema examination are discussed. The overwhelming majority of the lesions missed were located either in the cecum or the sigmoid colon.