Virtual colonoscopy — a new technology for colorectal cancer screening?

At the American College of Radiology Imaging Network meeting on September 28, researchers presented results from the National CT Colonography Trial. This study, funded by the National Institutes of Health (NIH), indicated that computerized tomographic colonography (CTC), or virtual colonoscopy, may be a viable option for colorectal cancer screening. The AGA Institute awaits the publication of the study results.

Colorectal cancer is the second leading cause of cancer-related deaths and affects men and women equally. Optical colonoscopy, the gold standard technique for colorectal cancer screening, has the advantage of offering both diagnostic and therapeutic options for patients. If a polyp or lesion is discovered during CT colonography, the patient must then undergo an optical colonoscopy to remove the lesion.

“There is a large number of patients who need colorectal cancer screening but put off the test. CT colonography may encourage reluctant patients to talk with their doctors about screening,” notes Robert S. Sandler, MD, MPH, AGAF, president-elect of the AGA Institute. “Virtual colonoscopy or CT colonography isn’t yet widely accepted for all indications, paid for by Medicare or reimbursed by most insurance companies. However, it’s never too early for patients to begin discussing colon cancer screening with their physician and to determine the screening method that is most appropriate for them. Many patients will prefer the definitive optical colonoscopy.”

In September, the AGA Institute issued standards for the performance of virtual colonoscopy. The AGA Institute will host a course on CT Colonography on March 7-8, 2008, in Washington, DC. To learn more about AGA Institute initiatives on CTC, please visit the AGA Web site at www.gastro.org.

Guidelines from multiple agencies and professional societies, including the AGA Institute, underscore the importance of colorectal cancer screening for all individuals 50 years of age and older (younger for certain groups known to be at higher risk). The U.S. Preventive Services Task Force, the U.S. Multi-Specialty Task Force and others have published recommendations for screening for colorectal cancer, the second-leading cause of cancer deaths in the United States. Currently, recommended screening tests include colonoscopy, flexible sigmoidoscopy, barium enema and fecal occult blood tests.

An estimated 112,340 new cases of colon cancer and an estimated 41,420 cases of rectal cancer will be diagnosed this year, according to the National Cancer Institute. More than 52,000 Americans will die from colorectal cancer in 2007. Colorectal cancer rates have been decreasing steadily over the past several decades due to an increase in awareness and screening.