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

search, 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.

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