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Colonoscopy has largely replaced the barium enema (BE) for surveillance of patients with previous adenomatous polyps. However, colonoscopy is more expensive and slightly more risky, so determining whether it is substantially more accurate than BE is important. In this multicenter study, researchers performed double-contrast BE followed by colonoscopy in 580 patients undergoing surveillance 1 to 6 years after removal of newly diagnosed adenomatous polyps.
Researchers conducted 862 paired examinations; colonoscopists were blinded to the findings of the preceding BE. One or more adenomas were found during 242 colonoscopies; BE detected adenomas in only 94 (39 percent) of these cases. BE was significantly more likely to identify large adenomas (…