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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:9/17/2008

ls in clinical medicine. Until a radiographic test can meet that standard, gastroenterologists will continue to champion the lifesaving potential of colonoscopy," Foxx-Orenstein added.

Evaluating the Potential of CT Colonography - What Patients Should Know

When evaluating new potential screening technologies, including CT colonography, the ACG has focused its evaluation on several pieces of evidence including: sensitivity for identification of polyps of various sizes, standards for polyp removal, correlating patient risks (in this case from radiation exposure), frequency of exams and the economic impact to the healthcare system of separate diagnostic and therapeutic exams.

If all patients with a lesion measuring 5 mm or more on CT colonography in this study were referred for complete colonoscopy, the colonoscopy-referral rate would be 17 percent. In earlier findings by Dr. Pickhardt and his colleagues in 2004, at least 30 percent of patients undergoing virtual colonoscopy required conventional colonoscopy to remove polyps 6 mm or larger.

Radiation Risk

The issue of radiation exposure risk are long-term and lifetime risks. The results of the impact of patients undergoing CT and other radiologic exams for a variety of reasons will not be known for some time. With a proposed screening schedule of five years or less for CTC, depending upon the findings, the cancer risks from the CTC test itself are not insignificant. Although it is a challenge to define precise risk estimates related to low doses of radiation exposure, the ionizing radiation exposure from a single abdominal or chest CT may be associated with elevated risk for DNA damage and cancer formation. X-rays used in medical diagnostic procedures is the largest man-made source of radiation exposure to the population contributing some 14 percent of the total annual exposure from all sources. The U.S. Food and Drug Administration considers x-ray as a carcinogen.

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SOURCE American College of Gastroenterology
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