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Study Supports CT-Based 'Virtual' Colonoscopy to Spot Colon Cancer
Date:2/23/2012

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So, this new analysis of the data focused on findings from a subset of 477 participants aged 65 and older. These patients were much more likely than those younger than 65 to have large polyps -- 6.9 percent vs. 3.7 percent, respectively.

"Our goal in carrying out this secondary analysis was to determine if the accuracy of CT colonography to detect polyps of clinical concern in patients 65 and older is comparable to the test's accuracy for the 50-and-over population studied in the 2008 ACRIN trial," Johnson said in a journal news release. "We found no significant difference in the screening exam's performance between the two age groups," he said.

However, two gastroenterologists familiar with the study findings were more cautious.

"Colonoscopy is still the gold standard and best test to detect polyps of any size," said Dr Roshini Rajapaksa, a gastroenterologist at NYU Langone Medical Center and assistant professor at the NYU School of Medicine in New York City. "While CT colonography is less invasive and does not require sedation, it still requires a prep -- what many patients feel is the worst part of standard colonoscopy -- and if a polyp is found by CT colonography, in many cases, the patient will need to get a standard colonoscopy to remove it," she said.

Dr. David Bernstein, chief of the division of gastroenterology at North Shore University Hospital in Manhasset, N.Y. agreed that CT colonography may still not measure up to its rival.

"The current standard of care for the detection of precancerous polyps on screening standard colonoscopy is 25 percent, yet the authors report 'even if intermediate-sized polyps of 6 mm [0.6 centimeters] or larger were targeted for removal with standard colonoscopy, the colonoscopy referral rate would not exceed 12.6 percent,'" Bernstein said. This means that, "when compared to standard colonoscopy, the authors are reporting a precancerous detection rate of CT colonography which is 50 percent less
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