MTP6.08 Factors influencing use of CT Colonography over Colonoscopy as First line Investigation

Aim Colonoscopy is gold standard for investigating Colonic pathologies. CTC has however established itself as a very useful alternative tool in last 20 years. The primary aim of this study is to look at the factors influencing the clinicians and patients in opting for CT colonography (CTC) over conventional colonoscopy. Method This is a retrospective study. Patients undergone CTC from Jan. 2022 till Dec. 2022 were all included. The data was collected from radiology department, patients’ electronic record system, Unisoft GI reporting tool and Sectra Uni-view. Results A total of 389 patients, 246 Females (63.3%) and 143 Males (36.7%) underwent CTC. Age ranged between 28-98. 41% (n=159) had the CTC done as first line investigation. 59% (n=230) underwent CTC due to failed colonoscopy. Those patients undergoing CTC as first line investigation, 79 (49.7%) patients were considered unfit for colonoscopy due to frailty and multiple comorbidities. 53 (33.3%) patients preferred to have CTC instead of colonoscopy while 25 (15.7%) patients were booked for CTC due to previously failed colonoscopy. 1 (0.6%) Patient had history of colonic perforation and 1 (0.6%) Patient had recent surgery. Conclusion Overall Frailty and multiple comorbidities are the single most important influencing factor other than Patient preference and previously failed colonoscopy. We recommend using CTC as first line investigation in patients having low risk stratification based on FIT result (10-20) and patients presenting with constipation being the main symptom.