Radiology in the detection and prevention of colorectal cancer

Imaging techniques available for detection of colorectal cancer include barium enema, endoscopy, computed tomography (CT), ultrasound, magnetic resonance (MR) and immunoscintigraphy. Technical advances continue rapidly and prompt frequent re-evaluation of the optimal approach to management of these patients. Barium enema and colonoscopy are the main techniques for evaluation of symptomatic patients, although CT may well assume the predominant role within a few years. Variation in quality of barium enemas and colonoscopy poses a challenge for continuing medical education (CME) activities. Screening of asymptomatic individuals has to be considered separately for high, moderate and low risk population. Recommendations have to be made at present in the absence of evidence of effectiveness. Staging of disease pre-operatively is of limited value. Follow-up after surgery should be primarily clinical although endoscopy, CT, MR, ultrasound and immunoscintigraphy all have specific roles in the evaluation of patients suspected of harbouring recurrent disease.