The American College of Radiology (ACR) concurs with the American Cancer Society (ACS) that the latest published research and preliminary results of recently completed trials support the inclusion of Computed Tomographic Colonography (CTC) - also known as virtual colonoscopy - as a front-line screening exam for colorectal cancer.

In the first-ever joint consensus guidelines for colorectal cancer screening, released jointly by the ACS, ACR, and the U.S. Multi-Society Task Force on Colorectal Cancer (a group that comprises representatives from the American College of Gastroenterology, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy), CTC now is included as one of several options for colorectal cancer screening and prevention in average-risk adults age 50 years and older and recommended to be received once every five years.

CT colonography employs cutting-edge, virtual reality technology to produce three-dimensional "fly through" images that permit a thorough and minimally invasive evaluation of the entire colorectal structure. No sedation is required for the exam, allowing patients to resume normal activity, including driving, immediately after the procedure.
Since most colon cancers develop from polyps, and screening to find and remove these polyps can prevent colon cancer, an enormous opportunity exists to save lives with early detection. Yet, despite the known benefits of screening, studies indicate that the majority of Americans aged 50 and older are not being screened for the disease.

"CT colonography, as a minimally invasive exam, can potentially encourage many more people to choose to be screened for colorectal cancer. This could result in early detection of the disease for more patients, increasing the chance of successful treatment, and potentially reduce colorectal cancer deaths nationwide," said Arl Van Moore Jr., M.D., FACR, chair of the ACR Board of Chancellors.

Results of the National CT Colonography Trial coordinated by the American College of Radiology Imaging Network (ACRIN) and presented at the 2007 ACRIN Fall Meeting suggest CTC is comparable to optical colonoscopy for the detection of cancer and clinically significant polyps when state-of-the-art techniques are applied and images are read by radiologists trained in the procedure. Results of the ACRIN trial are expected to be published later this spring.

To ensure acceptable, consistent levels of performance, quality assurance measures should be implemented by all providers who offer this test. The American College of Radiology has published practice guidelines for CTC, and has outlined practice-based quality metrics.

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