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Eur Radiol. 2011 Oct;21(10):2046-55. doi: 10.1007/s00330-011-2154-y. Epub 2011 May 31.

Patient acceptability of CT colonography compared with double contrast barium enema: results from a multicentre randomised controlled trial of symptomatic patients.

Collaborators (171)

Dadswell E, Kanani R, Wooldrage K, Rogers P, Edwards R, Shah U, Kralj-Hans I, Ghanouni A, Pack K, Waddingham J, Thomson A, Verjee A, Monk C, Kanani R, Dadswell E, Ghanouni A, Muckian J, Gibbons N, Bastable D, Coni L, Martin J, Stephenson S, Jackson C, Wormald A, Beech D, Lynn C, Bloor C, Wilkinson S, Pickles L, Scothern J, Hennedy A, Larkin T, Pearson P, Preston S, Smith L, Wright L, Blackstock J, Thomas R, Young L, Butler-Barnes J, Adamson V, Larcombe T, Bradshaw V, Chapman S, Slater M, Stylan J, Wood D, Bradbury J, Breedon J, Coakes M, Crutch L, Leyland A, Pringle W, Rowe L, White M, Worley A, Kumar D, Gandy M, Pascoe J, Wood J, Cook W, Memory Y, Avery M, Pearson K, Shivapatham D, Thomas S, Ong C, Poppinga-Scholz B, Shanahan B, Turner L, Fellows K, Duffy A, Owen A, Usansky A, Naim F, Bohra V, Prabhudesai S, Hayes M, Lancelotte N, James T, Johnston S, Stevenson J, Whetter D, Bartram C, Burling D, Gupta A, Halligan S, Marshall M, Taylor SA, Higginson A, Atchley J, Kay C, Lowe A, Maskell GF, Taylor A, Tan E, McGregor J, Hayward S, Philips A, Noakes M, Zaman S, Guest P, McCafferty I, Riley P, Tattersall D, Jobling C, Dhingsa R, Jackson SA, Fox BM, Shirley J, Kumar M, Blunt D, Roddie M, Slater A, Sukumar SA, Hughes N, Woolfall P, Saunders B, Northover JM, Goggin P, O'Leary D, Ausobsky MJ, Beckett C, Davies J, Griffith J, Steward M, Crighton I, Bronder C, Brown C, Higham A, Lea R, Meaden C, Morgan W, Patel P, Nasmyth G, Williamson M, Cade D, Morton D, Scholefield J, Hosie K, Whitehead E, Conlong P, Rameh B, Rate A, Richards D, Bansi D, Buchanan G, Dawson P, Martin J, Smith G, Theodorou NA, Thillainayagam A, Cunningham C, Travis S, Hyde GM, Jones DJ, O'Dwyer ST, Ziprin P, Edwards CD, Burton S, Fabricius P, Gudgeon M, Jourdan I, Rutter M, Altman DG, Steele R, Walker A, Dixon A, Foulds-Wood L, Marteau T, Valori R.

Author information

Department of Epidemiology and Public Health, University College London, London, UK.



To determine patient acceptability of barium enema (BE) or CT colonography (CTC).


After ethical approval, 921 consenting patients with symptoms suggestive of colorectal cancer who had been randomly assigned and completed either BE (N = 606) or CTC (N = 315) received a questionnaire to assess experience of the clinical episode including bowel preparation, procedure and complications. Satisfaction, worry and physical discomfort were assessed using an adapted version of a validated acceptability scale. Non-parametric methods assessed differences between the randomised tests and the effect of patient characteristics.


Patients undergoing BE were significantly less satisfied (median 61, interquartile range [IQR] 54-67 vs. median 64, IQR 56-69; p = 0.003) and experienced more physical discomfort (median 40, IQR 29-52 vs. median 35.5, IQR 25-47; p < 0.001) than those undergoing CTC. Post-test, BE patients were significantly more likely to experience 'abdominal pain/cramps' (68% vs. 57%; pā€‰=ā€‰0.007), 'soreness' (57% vs. 37%; p < 0.001), 'nausea/vomiting' (16% vs. 8%; p = 0.009), 'soiling' (31% vs. 23%; p = 0.034) and 'wind' (92% vs. 84%; p = 0.001) and in the case of 'wind' to also rate it as severe (27% vs. 15%; p < 0.001).


CTC is associated with significant improvements in patient experience. These data support the case for CTC to replace BE.

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