"Our positive experience with virtual colonoscopy screening covered by health insurance demonstrates its enormous potential for increasing compliance for colorectal cancer prevention and screening," said lead author Perry J. Pickhardt, M.D., associate professor of radiology at The University of Wisconsin Medical School in Madison. "In addition, recent technical improvements have resulted in even better performance results."
Colorectal cancer remains the second leading cause of cancer mortality in the United States, and the American Cancer Society (ACS) estimates that there will be 148,610 new cases diagnosed in 2006 and 55,170 deaths. The disease is largely preventable through screening for colon polyps, which are benign growths that may develop into cancer if not removed. ACS recommends that people at average risk for colorectal cancer begin regular colorectal cancer screening at age 50, but current compliance with this recommendation remains well below 50 percent. Many people resist screening because of the discomfort and inconvenience caused by the standard optical colonoscopy test.
"Our goal is not to take patients away from existing strategies like optical colonoscopy, but rather to attract those who are currently not being screened at all," Dr. Pickhardt said.
Virtual colonoscopy is less invasive than optical colonoscopy and produces precise and detailed 3-D "fly-through" images of the entire colon's interior without having to insert a scope. With virtual colonoscopy screening, there is essentially no risk of bleeding or of perforating the colon. There is no need for intravenous sedation, and the procedure is less costly than conventional colonoscopy. It also is more convenient, typically taking 10 minutes or less, because patients need not recover from sedation.
"Both virtual colonoscopy and optical colonoscopy are excellent screening tests," Dr. Pickhardt said. "The advantages of virtual colonoscopy over optical colonoscopy at our institution are that it is safer, faster, less costly, more convenient, involves an easier bowel prep, and yet is just as effective for detecting important polyps and cancers."
In April 2004, local third-party insurance coverage was initiated for virtual colonoscopy screening by the major managed care providers in the Madison area. Over a one-year period, the researchers performed virtual colonoscopy screening exams on 1,110 asymptomatic adults, consisting of 585 women and 525 men with a mean age of 58.1 years.
Large (10 millimeters [mm] or more) colorectal polyps were identified in 43 (3.9 percent) of patients. Medium-sized lesions (6 mm - 9 mm) were identified in 77 (6.9 percent) patients. Patients without polyps 6 mm or larger were advised to follow a routine screening interval of five years. Most patients with medium-sized lesions chose to undergo follow-up with virtual colonoscopy. If all the patients with either a polyp larger than 6 mm or a nondiagnostic segment had undergone subsequent optical colonoscopy, the maximum referral rate would have been 11.9 percent.
Seventy-one of the 1,110 patients (6.4 percent) underwent subsequent optical colonoscopy. Sixty-one of these procedures were performed on the same day as virtual colonoscopy to avoid the need for repeat bowel preparation. The optical colonoscopy findings were in agreement with the virtual colonoscopy findings in 65 of the 71 patients.
The high rate of accuracy coupled with the low necessity for subsequent optical colonoscopy show virtual colonoscopy to be an attractive screening tool for colorectal cancer.
"In our experience, providing a less invasive, yet equally effective screening option like virtual colonoscopy has drawn many adults off the sidelines," Dr. Pickhardt said. "Since colorectal cancer is uniquely preventable, widespread virtual colonoscopy screening could lead to a significant reduction in mortality from this deadly disease."
Dr. Pickhardt anticipates that the positive clinical results of this study will lead to further acceptance from the medical community and that insurance coverage on the national level should start to take place within the next one to two years.
Maureen Morley | EurekAlert!
NIST scientists discover how to switch liver cancer cell growth from 2-D to 3-D structures
17.11.2017 | National Institute of Standards and Technology (NIST)
High speed video recording precisely measures blood cell velocity
15.11.2017 | ITMO University
The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.
Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...
Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.
That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...
Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.
During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....
The quantum world is fragile; error correction codes are needed to protect the information stored in a quantum object from the deteriorating effects of noise. Quantum physicists in Innsbruck have developed a protocol to pass quantum information between differently encoded building blocks of a future quantum computer, such as processors and memories. Scientists may use this protocol in the future to build a data bus for quantum computers. The researchers have published their work in the journal Nature Communications.
Future quantum computers will be able to solve problems where conventional computers fail today. We are still far away from any large-scale implementation,...
Pillared graphene would transfer heat better if the theoretical material had a few asymmetric junctions that caused wrinkles, according to Rice University...
15.11.2017 | Event News
15.11.2017 | Event News
30.10.2017 | Event News
17.11.2017 | Physics and Astronomy
17.11.2017 | Health and Medicine
17.11.2017 | Studies and Analyses