Repeat Colonoscopies Underused in High-Risk Patients

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In his study, Rex wanted to evaluate the impact of a new recommendation from the American College of Radiology, recommending that polyps 5 millimeters or smaller not be reported on CT colonography (CTC), also called virtual colonoscopy, a procedure in which a detailed picture of the colon is created by an X-ray machine linked to a computer. The recommendation also suggests those with one or two polyps that are 6 millimeters to 9 millimeters be offered CTC surveillance in three years instead of polyp removal.

Rex's team looked at more than 10,000 polyps over a five-year period after they had colonoscopies. They wanted to figure out how many patients would have been identified as higher risk if they had CTC as their first test instead of colonoscopy, doing so by evaluating the numbers and sizes of polyps.

If CTC had been used as the first test, and if the CTC had been 100 percent accurate at finding polyps over 5 millimeters, then 29 percent of all the patients and 30 percent of those over age 50 with high-risk polyps would have been classified as normal, he said.

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In another presentation, the shorter the interval between completing the bowel cleaning preparation required before colonoscopy and the start of the procedure, the better.

"Colonoscopy started within 14 hours of the last preparation had better quality," said study author Dr. Ali Siddiqui, an assistant professor of internal medicine at the University of Texas Southwestern Medical Center at Dallas.

His team gathered information over a three-month period on 378 outpatients who had colonoscopies done at a VA Medical Center.

The American Cancer Society expects more than 108,000 cases of colon cancer diagnoses this year, plus another 40,000 cases of rectal cancer. Almost 50,000 people in the United States will die of colorectal cancer this year, the society estimates.

More information

For more on colonoscopies, go to the National Institute of Diabetes and Digestive and Kidney Diseases.

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