Virtual colonoscopy option could improve cancer screening rates, study

by Nancy Ryerson, Staff Writer | January 16, 2013
CT colonography image
Courtesy RSNA
No one wants to prepare for a colonoscopy, but when patients were given the option of a virtual colonoscopy over a traditional one, screening compliance rates shot up, a new study from the Journal of the American College of Radiology found.

The study compared screening compliance at two different Navy medical centers, one with a robust CT colonography program (commonly known as virtual colonoscopy) and the other without. Screening compliance ranged from 33.8 percent to 67.9 percent without CTC and 33.8 percent to 84 percent with CTC.

CT colonography, or CTC, is a noninvasive colon cancer screening modality that has been found to be comparable to colonoscopy by the American Cancer Society, the ACR and the U.S. Multi-Society Task Force on Colorectal Cancer. However, it has not been added to the Healthcare Effectiveness Data and Information Set (HEDIS) list of compliant colon cancer screenings.
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"We wanted to demonstrate the potential benefit in terms of those compliance numbers for colon cancer screening with this newer modality," study author Dr. Brooks D. Cash, told DOTmed News.

Nationwide, colon cancer screening rates for adults aged 50 to 75 years can be as low as 54 percent in some parts of the country, according to the CDC. Colon cancer is the second most common cause of cancer deaths in the U.S.

"Patients are uncomfortable with the invasiveness of colonoscopy," Cash said. "Many of them have acquaintances or family members who have had difficult procedures. They're aware of the risks, which include bleeding or perforation. They don't want to get sedated, some don't want to get a family member to drive them home, or they don't want take the time off from work."

CT colonography does not require patients to be put under, and patients can return to work after the procedure. It is just as effective at finding large polyps and cancers as colonoscopy, though it does not detect small polyps as well, Cash said.

"We don't view this as a replacement to any of the other tests, but merely as an additional option for patients," said Cash. "Eventually what we hope is that this technology, based on the literature, will be re-reviewed by the U.S. Preventive Services Task Force and Medicare, receive an endorsement, and eventually find its way into the compliance list as well."

Unfortunately, the prep is the same for CTC as for colonoscopy. No break there as of yet.

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