In April 2004, local third-party insurance coverage was initiated for virtual colonoscopy screening by the major managed care providers in the Madison area. Over a one-year period, the researchers performed virtual colonoscopy screening exams on 1,110 asymptomatic adults, consisting of 585 women and 525 men with a mean age of 58.1 years.

Large (10 millimeters [mm] or more) colorectal polyps were identified in 43 (3.9 percent) of patients. Medium-sized lesions (6 mm - 9 mm) were identified in 77 (6.9 percent) patients. Patients without polyps 6 mm or larger were advised to follow a routine screening interval of five years. Most patients with medium-sized lesions chose to undergo follow-up with virtual colonoscopy. If all the patients with either a polyp larger than 6 mm or a nondiagnostic segment had undergone subsequent optical colonoscopy, the maximum referral rate would have been 11.9 percent.


Seventy-one of the 1,110 patients (6.4 percent) underwent subsequent optical colonoscopy. Sixty-one of these procedures were performed on the same day as virtual colonoscopy to avoid the need for repeat bowel preparation. The optical colonoscopy findings were in agreement with the virtual colonoscopy findings in 65 of the 71 patients.

The high rate of accuracy coupled with the low necessity for subsequent optical colonoscopy show virtual colonoscopy to be an attractive screening tool for colorectal cancer.

"In our experience, providing a less invasive, yet equally effective screening option like virtual colonoscopy has drawn many adults off the sidelines," Dr. Pickhardt said. "Since colorectal cancer is uniquely preventable, widespread virtual colonoscopy screening could lead to a significant reduction in mortality from this deadly disease."

Dr. Pickhardt anticipates that the positive clinical results of this study will lead to further acceptance from the medical community and that insurance coverage on the national level should start to take place within the next one to two years.

Radiology is a monthly scientific journal devoted to clinical radiology and allied sciences. The journal is edited by Anthony V. Proto, M.D., School of Medicine, Virginia Commonwealth University, Richmond, Va. Radiology is owned and published by the Radiological Society of North America, Inc. (RSNA.org/radiologyjnl)

The Radiological Society of North America (RSNA) is an association of more than 38,000 radiologists, radiation oncologists, medical physicists and related scientists committed to promoting excellence in radiology through education and by fostering research, with the ultimate goal of improving patient care. The Society is based in Oak Brook, Ill. (RSNA.org)

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