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CT Scan Works As Well As Colonoscopy

aleftina
Posts: 102
Joined: Nov 2003

Science News

For anyone seeking to avoid the unpleasantness and discomfort of a colonoscopy, here's good news: A computed tomography (CT) scan that provides a "virtual colonoscopy" of the large intestine is just as adept at detecting signs of cancer as is a viewing device moved through the colon, a new study finds.

A team led by researchers at the National Naval Medical Center in Bethesda, Md., used a CT scanner to generate three-dimensional images of the colon, an emerging technique that seems to be more accurate than typical two-dimensional CT scanning. The 3-D images consistently revealed polyps growing inside the colon. Such growths aren't necessarily cancerous, but some can develop into tumors.

The scientists performed CT scans on 1,233 people, average age 58, who were free of signs of cancer. Next, without knowing the CT results, other doctors conducted a colonoscopy on each volunteer. In this procedure, a physician inserts a flexible, camera-tipped tube into a sedated patient's colon via the rectum and withdraws it gradually while watching a video screen for polyps.

In this generally healthy group of volunteers, only two cancerous polyps showed up. CT scanning spotted both, but colonoscopy found only one. Of 48 worrisome polyps at least 1 centimeter in diameter, 45 turned up in the CT scans and 42 were detected by the colonoscopy. Between them, the tests turned up 554 polyps deemed to have malignant potential.

"The results were quite comparable," says study coauthor Pauline A. Mysliwiec, a gastroenterologist now at the University of California, Davis, Medical Center in Sacramento. The report appears in the Dec. 4 New England Journal of Medicine.

Patients spent an average of 14 minutes in the CT scanning room, where they received a sometimes-uncomfortable infusion of air into the colon. A colonoscopy took 32 minutes during which patients were sedated to a dreamlike state.

Colon cancer kills nearly 60,000 people annually in the United States, even though it is largely preventable through polyp detection and removal. The Centers for Disease Control and Prevention in Atlanta reported earlier this year that fewer than half of U.S. residents over age 50 have had a colonoscopy or a sigmoidoscopy, a similar but less-thorough exam.

A physician who detects polyps during a colonoscopy routinely removes them using equipment built into the scope. A CT scan revealing a large polyp triggers a colonoscopy for the growth's removal.

However, colonoscopy has drawbacks as a screening tool. It risks perforating the colon, and the sedated patient requires up to an hour of recovery time and a ride home, say Martina M. Morrin and J. Thomas LaMont of Harvard Medical School in Boston in an article accompanying the new study. If the new findings are replicated and doctors can agree on how big a CT-detected polyp needs to be to warrant immediate removal, then "virtual colonoscopy is ready for prime time," Morrin and LaMont say.

The price tag for such a CT scan is "still being worked out," says John H. Bond, a gastroenterologist at the University of Minnesota and the Veterans Affairs Medical Center in Minneapolis. Once medical authorities agree that a CT scan is as good as colonoscopy, he predicts that Medicare and insurance companies will pay for CT-probably within the next 2 years.

"A lot of people are going to opt for this procedure," Bond says.

pattieb
Posts: 176
Joined: Mar 2003

Well I for one will opt for this new ct scan. Hope it is before 2 years.
Pattie

spongebob's picture
spongebob
Posts: 2600
Joined: Apr 2003

Hmmm... maybe I should ask for one of these next time I go for my check up at Bethesda.

Thanks for the scoop, Al.

aleftina
Posts: 102
Joined: Nov 2003

I think this will be a better test. I had colonoscopy that showed clean colon, but cancer came back outside my colon that colonoscopy didn't show of course. If it didn't press on my uriters and I didn't have kidney failure, we wouldn't know I had cancer.

spongebob's picture
spongebob
Posts: 2600
Joined: Apr 2003

Good point. Sad to say that getting them to pony-up for the tests is often the hard part! I asked for four years to get a colonoscopy done because of my familial history of CC. It wasn't until I was really sick four years later that they finally did one and found out I had Cx! If they had done one four years earlier when I started asking, they would have been able to catch me at Stage 0 or stage 1. Unfortunately I was "too young" for a scope.

(morons)

aleftina
Posts: 102
Joined: Nov 2003

I know,I was 46 and was complaining on severe abdomen pains, and my physician kept sending me for altrasound until I had uncontrollable bleeding, he sent for colonoscopy, at which point I was Stage III. Needles to say, I fired him.

spongebob's picture
spongebob
Posts: 2600
Joined: Apr 2003

He's just lucky you didn't go after him for malpractice.

aleftina
Posts: 102
Joined: Nov 2003

I hope too this test is availabel soon, so it makes it easier for people to go. It should save a lot of lives.

2bhealed's picture
2bhealed
Posts: 2084
Joined: Dec 2001

monika don't feel bad. My sister died of adenocarcinoma of the small intestine 11 years ago and NOT ONE doctor since then had EVER suggested I get a colonoscopy so it did not occur to me either until I had severe abdominal pain. My physician at the time of dx was the FIRST one to suggest it when she heard of my sister's death.....and I had been to plenty of other doctors....surgeon for hemorrhoids and fissures....gyno for ovarian cysts requiring surgery....

Talk about DUH!!! :-) Too late to sue in my case and I sure could use the money to pay off my ENORMOUS debt from my treatments!!!

C'est la vie.

peace, emily.....the radical one

aleftina
Posts: 102
Joined: Nov 2003

When you are diagnosed with cancer, suing someone doesn't seem that important. The thought crossed my mind, but I would probably have a hard time proving my case, I had no colon cancer in the family and I was 46. But he was dumb, even after I told him about the bleeding, he said it was probably a polip and we should check it out, meaning colonoscopy. So I wasn't in a hurry to go for the colonoscopy, I waited till my vacation. The surgeon told me right there and then I had cancer and we should operate immediately. I never went back to the physician. I still don't have one, I just don't believe in them any more.

Pewter
Posts: 24
Joined: Aug 2003

As you all know, the most unpleasant part of the colonoscopy is the prep; most actually look forward to the sedation (as opposed to the scope discomfort!) Unfortunately, virtual colonoscopy stills requires a clean colon, hence the prep the day before. In addition, you are awake as they are inflating your colon with air, albeit for a briefer time, but nonetheless feeling it much like a lower GI Xray. It is also my understanding that they are really just focusing on the colon, and still use regular CT scans with infusion to survey the other structures. So you see, we will be subject to multiple tests anyway, and the virtual colonoscopy is just another method to look "inside" the colon. Is anything fair?

spongebob's picture
spongebob
Posts: 2600
Joined: Apr 2003

I say it's all just a pain in the @$$!

aleftina
Posts: 102
Joined: Nov 2003

And I got all my hopes up. :(

aleftina
Posts: 102
Joined: Nov 2003

I don't know, is this good news:

Measuring the Risk for Colorectal Cancer

MONDAY, Dec. 15 (HealthDayNews) -- An index that may help determine a person's risk levels for colorectal cancer and whether a colonoscopy is required is being developed by researchers at Indiana University School of Medicine.

The results of their initial work appear in the Dec. 16 issue of the Annals of Internal Medicine.

The researchers reviewed the colonoscopy results of almost 2,000 people over age 50 and identified factors associated with an increased probability of finding the disease in the upper colon, an area that can only be viewed using a colonoscope.

Using this information, they developed a risk index and tested it using data from an additional 1,031 patients in the same age bracket.

Three factors were identified as increasing the chances of finding advanced, pre-malignant growths in the upper colon. They include: older age; being male; and having certain types and sizes of polyps in the lower colon, which can be seen using sigmoidoscopy, which is less costly and invasive than colonoscopy.

"The risk index we have developed may identify low-risk people whose probability of advanced precancerous growths in the upper colon is about one in 250," lead researcher Dr. Thomas F. Imperiale, a gastroenterologist, says in a prepared statement.

"This index is a first step toward identifying people who do not require colonoscopy sigmoidoscopy; however, colonoscopy could be considered later in life, as their risk changes," Imperiale says.

JimN
Posts: 10
Joined: Jan 2004

Can anyone get this CT Scan? What is the pricetag?

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