Virtual Colonoscopy Effective for Average Risk People

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CT colonography found nine out of 10 lesions that were 10 millimeters or larger. And, for smaller lesions -- those over 6 millimeters but less than 10 millimeters -- virtual colonoscopy found nearly eight out of 10.

In an accompanying editorial in the journal, Dr. Robert Fletcher, of Harvard Medical School, pointed out that while this study shows CT colonography is effective, there is a downside to this technology. If abnormalities are found, a patient still has to undergo colonoscopy, and CT colonography may find "extracolonic findings" that require further investigation. Of additional concern is that if someone used virtual colonoscopy exclusively and repeated the test every five years, the cumulative radiation dose might be too high, he said.

"These concerns do not rule out CT colonography as a screening test, but they need to be considered," Fletcher wrote.

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The American Gastroenterological Association issued a news release discussing the study's findings. It said, in part, "Despite the perception that CT colonography is less invasive than traditional colonoscopy, it requires similar bowel preparation as for a colonoscopy. Patients need to understand that a prep is required for CT colonography, and if a polyp is found, it must be removed through a subsequent colonoscopy. Only colonoscopy can prevent colorectal cancer, by removing pre-cancerous polyps."

The second study included nearly 2,500 people with an average risk of colon cancer. The average age of the study participants was almost 57, and slightly more than half were men. Each had an initial colonoscopy, and then about half returned to be rescreened again an average of five years later.

"We found no colon cancer after five years, and the risk of advanced precancerous polyps was very low," said the study's lead author, Dr. Thomas F. Imperiale, a professor of medicine at Indiana University School of Medicine and a research scientist at the Regenstrief Institute in Indianapolis.

"The average person should be reassured by these findings if they've had a high quality colonoscopy, they need not be screened again for at least five years," he said.

More information

Learn more about colon cancer screening options from the American Cancer Society.

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