Double-contrast barium-enema examination and endoscopy in the detection of polypoid lesions in the cecum and ascending colon.

Fifty-three patients with 54 polypoid lesions in the ascending colon and cecum underwent colonoscopy and double-contrast barium-enema examination (DC-BE). Colonoscopy could not completely examine the cecum in three patients (failure rate 6%) and DC-BE had four false positive results. Colonoscopy detected 40 lesions (sensitivity 78%) and DC-BE 45 lesions (sensitivity 88%). A carcinoma and a villous adenoma were missed by both methods. The overall accuracy for colonoscopy was 80%, 76% if corrected for unsuccessful procedures; DC-BE showed accuracy rates of 82% and 83%. In combination, the two methods had 97% accuracy. This study shows that DC-BE is slightly better than colonoscopy for evaluating well-prepared patients with suspected polypoid lesions in the right colon, but stresses the complementary nature of the two methods and the need for repeating negative examinations by one modality in the presence of a positive result by the other.