Barium enemas of carcinoma of the colon: Sensitivity of double- and single-contrast studies

A total of 1,140 primary colorectal carcinomas found in 1084 patients during a 5 1/2 -year period (1976 to mid-1981) at the Mayo Clinic was reviewed to evaluate the accuracy of detection by the double- and single-contrast barium enema examinations. Both methods were equally sensitive in detecting colon cancer above the proctoscopic level. The error rate (ulcerative colitis excluded) was 4.8% for the single-contrast enema and 4.7% for the double-contrast study. Neither type of examination was superior in finding smaller lesions or earlier staged lesions. Several causes for error were identified: fluoroscopic inexperience, technical factors, misinterpretation of radiologic findings, and distraction.