High-def scopes for colonoscopy sufficient to diagnose polyps

Investigators at the Mayo Clinic in Jacksonville, Florida, have determined that experienced gastroenterologists can use high-definition optical lenses during colonoscopies to accurately assess polyps.

"A colonoscopy is a fairly expensive procedure, and a large portion of the cost is the pathological analysis of polyps that are removed to check whether they are precancerous or benign--a check that determines when a patient needs another colonoscopy," senior investigator and gastroenterologist, Michael Wallace, M.D. said in an announcement.

In the study, published in the December issue of Gastrointestinal Endoscopy, Wallace and his colleagues found that when gastroenterologists use high-definition optical scopes during a colonoscopy, an optical diagnosis--or virtual biopsy--was 96 to 97 percent accurate (depending on the generation of scope used) in assessing whether a polyp was precancerous or benign.

The investigators also found that physicians had high adenoma detection rates of 50 to 52 percent. Other studies have shown that giving patients the option to undergo virtual colonoscopy increases compliance rates.

"Current national benchmarks recommend an adenoma detection rate of at least 20 percent," Wallace said. "The more adenoma polyps that are detected, the lower the risk is of getting colon cancer."

Wallace added that his research shows that it's possible to use an optical scope to perform accurate colonoscopy while bypassing the pathology laboratory, all of which cuts costs.

A further advantage of the "virtual" biopsy, according to Wallace, is that a patient can be informed of the results of the procedure immediately after it has been performed, rather than having to wait for a pathology result.

A proposed decision in August by the Centers for Medicare & Medicaid Services to cover a stool DNA colorectal cancer screening test prompted the American College of Radiology to ask for coverage of CT colonography (or virtual colonoscopy), as well.

To learn more:
- see the study in Gastrointestinal Endoscopy
- see the announcement