The latest study, conducted at 15 medical centers by the American College of Radiology and Imaging Network and published in the September issue of the New England Journal of Medicine, “provide[s] evidence that CT colonography is approximately as successful as standard colonoscopy in the detection of colonic polyps,” says the story, which appears on page D1 of the Oct. 28 edition. “It is also much easier for patients, does not require the patient to be sedated, miss a full day of work, or have someone to drive them home.”
While the report says the procedure costs about half of what a screening colonoscopy does, it notes that many patients will have to undergo conventional colonoscopy anyhow, because polyps are discovered. This raises the major weakness of the CT approach: Virtual colonoscopy is not “definitive,” because it does not allow for polyps to be removed at the time of screening.
The report also neglects the updated Screening for Colorectal Cancer: U.S. Preventive Services Task Force Recommendation Statement, which will be published in the Nov. 4 edition of the Annals of Internal Medicine. That recommendation states that “the evidence is insufficient to assess the benefits and harms of computed tomographic colonography” and that “there is potential for both benefit and harm.Potential harms arise from additional diagnostic testing and procedures for lesions found incidentally, which may have no clinical significance. This additional testing also has the potential to burden the patient and adversely impact the health system.”
Further, there is potential for a turf war, because radiologists and not gastroenterologists administer and read the results of virtual colonoscopies. Colonoscopy is the most commonly performed procedure among GI surgeons, and the most commonly performed procedure in ASCs.
View the full WSJ article here.
