CT colonography remains an important test for colorectal cancer

We read with interest the recent article by Cash et al comparing colon capsule (CCE) and CT colonography (CTC) with optical colonoscopy (OC) for detecting colonic polyps and colorectal cancer (CRC) in a screening population.1 The study reports low CTC detection rates for ≥6 mm and ≥10 mm polyps of only 8.6% and 6.3%, respectively. These were much lower than the detection rates seen for CCE and OC. These results contradict larger trials, where the performance of CTC and OC tests are similar. The Dutch COCOS randomised controlled trial (RCT) in a screening population ultimately reported identical advanced neoplasia detection rates for CTC and OC.2 3 The UK SIGGAR RCT reported identical detection rates of 11% for large polyps or CRC.4 Earlier studies from the USA also support the use of CTC.5 6 The 8.6% …