Wake Forest University Baptist Medical Center researchers have found that "virtual" colonoscopy using a computer tomography (CT) scanner is considerably more expensive than the traditional procedure due to the detection of suspicious images outside of the colon.
"Virtual colonoscopy will certainly play a role in the future of colon cancer screening," said gastroenterologist Richard S. Bloomfeld, M.S., M.D., assistant professor of medicine at Wake Forest Baptist and a member of the research team. "It is important to understand the implications of findings outside the colon before we advocate wide-spread use of this technology."
Virtual colonoscopy, also known as CT-colonography (CTC), was developed at Wake Forest Baptist. It allows doctors to use CT scanners to look at the colon to detect polyps (small growths in the colon that may become cancerous if they are not removed) and cancers. Virtual reality software allows them to look inside the body without having to insert a long tube (conventional colonoscopy) into the colon or without having to fill the colon with liquid barium (barium enema).
Research performed at Wake Forest Baptist and elsewhere has shown that CTC is better able to see polyps than barium enemas and is nearly as accurate as conventional colonoscopy. Most patients report that CTC is more comfortable than either procedure.
The current research evaluated CTC for use as a colorectal cancer screening tool in an average risk population. It revealed that findings outside the colon --such as lung nodules and indeterminate kidney lesions--added about $231 to each CTC performed because of the need for additional testing. Those tests often reveal that the extra-colonic findings are benign.
"Finding things outside of the colon on a virtual colonoscopy can be a good thing or a bad thing," Bloomfeld said. "It's a good thing if we find unknown conditions that are treated, but a bad thing if we put people through more invasive tests with risks and additional costs for no reason."
Bloomfeld and others will present their findings on Wednesday, Oct. 25 at the American College of Gastroenterology annual scientific meeting in Las Vegas, Nev. An abstract of the study was printed in the September 2006 issue of The American Journal of Gastroenterology.
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