An Assessment of the Accuracy of the Clinical and Radiological Diagnosis of Carcinoma of the Colon

An attempt has been made to assess the accuracy of clinical and radiological diagnosis in 200 cases of carcinoma of the colon that have been seen at this hospital over a period of five years. Of the 123 cases examined by means of a barium enema, a lesion was shown in 96 per cent, of which all but 7 per cent were correctly interpreted as carcinomata. The caecum appears to be the part in which error is most likely, but it is considered that with the use of tannic acid, and in particular of routine air insufflation, the chances of error are very much reduced. Since the use of these have become more common, and after more efficient apparatus had been installed at the hospital, no enema investigations have been reported as normal when a lesion has subsequently been shown to be present, although in some cases a wrong diagnosis has been made. These results compare favourably with those in other series that have been reviewed. It has also been shown that the number of patients in whom a carcinoma is incorrectly diagnosed is small. If in doubt, surely one should always err to the side of neoplasm.