Wessex regional radiology audit: barium enema in colo-rectal carcinoma.

In the first Wessex regional radiology audit, a retrospective comparison of pathology and radiology reports was made to determine rates of demonstration and reporting of colo-rectal carcinoma on barium enema. Barium enema films were analysed by peer review in cases of discrepancy. The standard set was 100% demonstration and 100% diagnosis of colo-rectal carcinoma on a barium enema undertaken in the 12 months preceding histological diagnosis. The carcinoma demonstration rate was 97% and carcinoma reporting rate 85%. Of 1351 patients with carcinoma, 557 had a barium enema in the preceding 12 months. Four hundred and seventy-one enema reports satisfactorily recorded the malignant lesion (85%). The reasons for non-reporting of a carcinoma were failure to demonstrate the lesion (18 cases, 3%), failure to perceive a demonstrated lesion (23 cases, 4%) and failure to analyse a perceived lesion (45 cases, 8%). Any improvement in demonstration cannot be estimated, but 94% of carcinomas should be reported when improved reporting techniques are instituted and the audit loop is closed.