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Despite Advances in the Accuracy of CT Colonography in Detecting Polyps, Digestive Health Experts Urge Patients to Consider Risks and Realities
Date:10/4/2007

BETHESDA, Md., Oct. 4 /PRNewswire-USNewswire/ -- New research from the University of Wisconsin comparing optical colonoscopy to CT colonography published in the New England Journal of Medicine today raises several important issues for the public about colorectal cancer screening using a CT scan of the abdomen. "Gastrointestinal physicians are committed to preventing colorectal cancer, and to advancing new frontiers in medicine. While all of us on the front lines of battling colorectal cancer will welcome effective and clinically proven new tools, the evidence needs to be closely evaluated and patients need to recognize that a virtual test is not without significant potential risks in its own right," commented Dr. David Johnson, M.D., FACG, President of the American College of Gastroenterology.

The Wisconsin study in today's NEJM compared CT colonography (CTC) performed for screening in 3120 adults with primary optical colonoscopy (OC) in 3163 similar consecutive adults. A major limitation of the study was it was not randomized, patients chose their preferred screening method. Referral for polypectomy during optical colonoscopy was offered for all polyps detected by CT colonography of at least 6 mm in size. Patients with one or two polyps in the range 6 to 9 mm were offered the option of follow-up surveillance by CT colonography. The researchers do not report whether CTC identified smaller polyps, which would routinely be removed according to established practice guidelines because it is impossible to reliably identify which small adenomas will become cancerous.

CTC and OC found similar rates of advanced neoplasms and cancers. About 8 percent of CTC screenings resulted in referrals for OC for removal of suspicious polyps. The total numbers of polypectomies in the CTC and OC groups were 561 and 2434, respectively, so far more potentially cancerous polyps were removed by colonoscopy. Seven perforations occurred in the OC group during screening, and
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SOURCE American College of Gastroenterology
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