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So-called virtual colonoscopy is just as effective in screening healthy adults for colon cancer as conventional colonoscopy, a study concludes today.
Researchers hope their results -- more favorable than other studies of the test -- will spur reluctant Americans to get screened for colon cancer, the second-deadliest cancer in the USA, accounting for 60,000 deaths a year. Whether that will happen is unknown because virtual colonoscopy is more invasive, and uncomfortable, than its name suggests.
Colon cancer is thought to arise from benign polyps that take years to become malignant. Finding and removing polyps cuts the risk of being diagnosed with the disease or, at least, dying from it. But only a third of Americans older than 50 have ever been screened with sigmoidoscopy -- a scope inserted into the rectum and lower part of the colon -- or colonoscopy.
Virtual colonoscopy doesn't require sedation because it uses CT scanning, not a tube snaked through the colon, to look for polyps. Patients can drive to work right after the procedure.
But for now, virtual colonoscopy, like the conventional kind, still requires the unpleasant task of bowel cleansing. And it also requires insertion of a short tube into the rectum so the colon can be inflated for better viewing. Most of the new study's 1,233 patients, who underwent virtual and optical colonoscopy in the same day, actually said the latter was less painful, but that could be due to sedation. The findings, to be published Thursday in The New England Journal of Medicine, were presented at the Radiological Society of North America meeting in Chicago.
''We have yet to understand whether this is going to bring in tons of people who are not doing testing,'' says Douglas Rex, an Indiana University gastroenterologist familiar with the new study. ''It's not really a virtual test. American patients tend to value not being uncomfortable very highly.''
Unlike conventional colonoscopy, the virtual kind isn't covered by Medicare or insurance. One for-profit chain of imaging centers charges $950. Academic institutions charge less, making it slightly cheaper than a conventional colonoscopy.
Perhaps the biggest drawback is that patients with suspicious polyps must still have conventional colonoscopy to have them removed. Most people ''will want to have just one test and be done with it,'' says Wake Forest University gastroenterologist Ben Pineau, who collaborated on another, less favorable recent study of virtual colonoscopy.
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