Navigation Links
Virtual Colonoscopies Show Value for Some Patients, But Polyps Will Be Missed
Date:3/12/2009

ECRI Institute(R) Evidence Report Compares Effectiveness of CT Colonography to Colonoscopy

PLYMOUTH MEETING, Pa., March 12 /PRNewswire-USNewswire/ -- The value of CT colonography, also called virtual colonoscopy, is under debate as Medicare considers halting coverage of these procedures as a diagnostic method for detecting colorectal cancer and precancerous growths. Research findings from meta-analyses performed by ECRI Institute suggest that CT colonography appears most promising for screening asymptomatic, average-risk patients; however, it will miss some important polyps and cancer that would have been detected by colonoscopy. For asymptomatic high-risk patients and symptomatic patients, the percentage of patients correctly identified as having colorectal polyps or cancer may be too low to be useful.

"While some patients may prefer CT colonography, it may not be the best choice for everyone," Meredith Noble, an ECRI Institute researcher, notes. "Although CT colonography may be a useful alternative for patients with contraindications to colonoscopy or for whom colonoscopy cannot be completed, it may be less useful for patients who will inevitably require a subsequent therapeutic colonoscopy."

ECRI Institute (www.ecri.org), an independent, nonprofit organization that researches the best approaches to improving patient care, analyzed recent studies on the comparative effectiveness of CT colonography to traditional colonoscopy. Researchers focused on five key issues: 1) diagnostic performance for detecting clinically important polyps or cancer, 2) impact on long-term clinical outcomes, 3) patient preferences, 4) adverse events, and 5) impact of offering CT colonography on patient compliance with CRC screening recommendations. Researchers reviewed 17 publications of studies that reported on 7,460 patients.

According to ECRI Institute's research, CT colonography correctly identified between 86% and 95% of asymptomatic, average-risk patients with large polyps and cancers that were identified by colonoscopy and between 76% and 95% of symptomatic patients with large polyps and cancers. No firm conclusions could be drawn regarding the proportion of asymptomatic high-risk patients with important polyps that would be identified by CT colonography, but the studies ECRI Institute analyzed reported that CT colonography identified no more than 85% of these patients.

Long-term follow-up data is not available to compare the clinical outcomes (including side effects) of patients diagnosed or screened with CT colonography to the outcomes of patients who underwent colonoscopy. Information is also insufficient to gauge the possible long-term effects of repeat radiation exposure from CT colonography at the regular recommended intervals for colorectal cancer screening.

Nine studies ECRI Institute analyzed suggest that the majority of patients who underwent both CT colonography and colonoscopy for screening and diagnosis preferred CT colonography. However, a lack of evidence prevented ECRI Institute from determining whether offering CT colonography increases overall patient participation in colorectal cancer screening.

Both procedures involve the same patient bowel preparations. However, no sedative is administered for CT colonography. CT colonography involves taking a series of scans in a 15-20 minute procedure. Computer software translates the scans into a readable format. Because CT can only take pictures, suspicious polyps cannot be removed during this procedure. If suspicious polyps are identified, a subsequent colonoscopy should be scheduled, and if a facility cannot do it the same day as the colonography was performed, the patient must repeat the bowel preparation procedure for the follow-up colonoscopy.

For more information on ECRI Institute's Evidence Report, "Computed Tomographic (CT) Colonography for Colorectal Cancer Screening and Diagnosis," included in membership to ECRI Institute's Health Technology Assessment Information Service(TM), or for information about other comparative effectiveness reviews and health technology assessment services, e-mail htais@ecri.org, call (610) 825-6000, ext. 5060, or write to us at ECRI Institute, 5200 Butler Pike, Plymouth Meeting, PA, USA, 19462.

About ECRI Institute

ECRI Institute, a nonprofit organization, dedicates itself to bringing the discipline of applied scientific research to healthcare to uncover the best approaches to improving patient care. As pioneers in this science for 40 years, ECRI Institute marries experience and independence with the objectivity of evidence-based research. ECRI Institute is designated a Collaborating Center of the World Health Organization and an Evidence-based Practice Center by the U.S. Agency for Healthcare Research and Quality.


'/>"/>
SOURCE ECRI Institute
Copyright©2009 PR Newswire.
All rights reserved

Related medicine technology :

1. VirtualScopics Quantitative Imaging Provides Primary Endpoint in Cartilage Repair Pivotal Clinical Trial
2. Video: Large, Multi-Center Trial Demonstrates Comparable Accuracy for Virtual Colonoscopy and Standard Colonoscopy
3. MultiVu Video Feed: Major Trial Demonstrates Comparable Accuracy of Virtual Colonoscopy and Standard Colonoscopy
4. iCAD Initiates Clinical Study of Its Virtual Colonoscopy CAD in Partnership with ACR Image Metrix
5. ACR Supports American Cancer Society Inclusion of CT Colonography (Virtual Colonoscopy) as Recommended Screening Tool for Colorectal Cancer in New Screening Guidelines
6. iCAD Announces Partnership for Initiating Clinical Testing of Its Virtual Colonoscopy CAD Product
7. ACRIN Study Endorses Virtual Colonoscopy - Validation for Colon CAD Software Maker Medicsight plc
8. Progen Terminates PATHWAY Trial & Confirms Focus on Potential High Value Molecules and M&A
9. University of Miami Team Confirms Value of Monitoring Cell-Mediated Immunity Pre- and Post-Transplant in Management of Kidney Transplant Recipients
10. Synvista Therapeutics Presents New Preclinical Data Demonstrating the Value of Haptoglobin Genotype Testing In Diabetes at ACC Scientific Sessions
11. BRAVE-3 Questions Value of Abciximab in PCI for Heart Attack
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/24/2016)... 2016 According to a new ... Pen Needles, Safety Pen Needles), Needle Length (4mm, 5mm, ... Mode of Purchase (Retail, Non-Retail) - Trends & Global ... the market for the forecast period of 2016 to ... Billion by 2021 from USD 1.65 Billion in 2016, ...
(Date:6/24/2016)... Belgium , June 24, 2016 ... the appointment of Dr. Edward Futcher ... Non-Executive Director, effective June 23, 2016.Dr. Futcher was ... Nominations and Governance Committees.  As a non-executive member ... independent expertise and strategic counsel to VolitionRx in ...
(Date:6/23/2016)... 23, 2016  MedSource announced today that it ... software solution of choice.  This latest decision demonstrates ... to their clients by offering a state-of-the-art electronic ... establishes nowEDC as the EDC platform of choice ... clients.  "nowEDC has long been a preferred EDC ...
Breaking Medicine Technology:
(Date:6/26/2016)... ... 2016 , ... Pixel Film Studios Released ProSlice Levels, a Media Slicing Effect ... videos a whole new perspective by using the title layers in ProSlice Levels ... , ProSlice Levels contains over 30 Different presets to choose from. FCPX ...
(Date:6/25/2016)... ... 2016 , ... Austin residents seeking Mohs surgery services, can now turn to ... Dr. Russell Peckham for medical and surgical dermatology. , Dr. Dorsey brings specialization to ... fellowship in Mohs Micrographic Surgery completed by Dr. Dorsey was under the direction of ...
(Date:6/25/2016)... ... June 25, 2016 , ... ... recover from injury. Recently, he has implemented orthobiologic procedures as a method for ... is one of the first doctors to perform the treatment. Orthobiologics are substances ...
(Date:6/24/2016)... ... ... June 19, 2016 is World Sickle Cell Observance Day. In an effort ... holistic treatments, Serenity Recovery Center of Marne, Michigan, has issued a pain ... Disease (SCD) is a disorder of the red blood cells, which can cause episodes ...
(Date:6/24/2016)... ... June 24, 2016 , ... Comfort Keepers® of San Diego, ... and the Road To Recovery® program to drive cancer patients to and from their ... to ensure the highest quality of life and ongoing independence. Getting to and ...
Breaking Medicine News(10 mins):