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Study: Virtual colonoscopy effective at detecting polyps

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New England Journal of Medicine

A new study suggests that virtual colonoscopies are as effective as traditional colonoscopies at detecting large and medium-sized polyps that can be precursors to colon cancer, a conclusion that supports much broader use of this approach, the authors said.

Virtual colonoscopies involve a CT scan of the lower body, which unlike traditional colonoscopies, don't require anesthesia and aren't invasive. They're also much less expensive than the standard procedure, since there's no need for an anesthesiologist or pathologist to be present. Not only that, the use of virtual colonoscopies might help boost the number of people getting the procedure, which could have an impact on colon cancer detection overall, as traditional ones are so uncomfortable that many people avoid getting them, researchers said.

The study, which was published in the New England Journal of Medicine, involved 2,600 men and women tested at 15 medical centers, all of which got both a virtual and a standard colonoscopy. Researchers concluded that the virtual tests found 90 percent of large polyps or cancers found through traditional colonoscopies, a result that confirms earlier results from prior studies.

To get more information on virtual vs. traditional colonoscopies:
- read this piece from the Chicago Tribune

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Comments

Most doctors, specifically radiologists would not want the virtual colonoscopy as the screening test for colon cancer for many reasons.
1) The inconvenience of prepping for just a diagnostic exam that can clearly miss small tumors or polyps under 1 cm.
2) Radiation exposure(at the minimum at least 200 plain X-ray equivalent)
3) Colonoscopy is just as cheap and convenient, performed by a properly trained doctor with direct visualization of the mucosa, ability to pick up incipient cancers and flat lesions. It is virtually painless, completed under 30 minutes with removal of polyps in one step and if normal does not have to be repeated for 10 years. One does not have to take off for more than 1/2 day for the complete exam and polyp removal. In my office based practice, many of my patients go back to work the same day with the detailed report and pictures in their e.mail!
4) One role virtual colonoscopy can really fulfill is assessment foe the rare incomplete colon exams ( usually less than 2%) where the scope cannot be passed into the cecum. Since a patient would have already been prepped and have lot of air in the colon the CT exam can be done easily without any formal prep..
I see no sense in using virtual colonoscopy as a screening tool for cancer detection in populations, when you already have superb tools to get the job done right with minimal hassles. .

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