Standard Colonoscopy Recommended Over Virtual Colonoscopy
12/10/2003
OAK BROOK, Ill., -- The American Society for Gastrointestinal Endoscopy (ASGE) Technology Assessment Committee, led by Gregory Ginsberg, MD, University of PA Hospitals, Philadelphia, PA, recommends standard colonoscopy for patients rather than virtual colonoscopy.
The term virtual colonoscopy refers to the use of radiological (x-ray) techniques, including computed tomography (CT) and magnetic resonance (MR) scanning, with computers to produce pictures or images of the colon.
Supporters of virtual colonoscopy recommend the test as an alternative to standard colonoscopy performed with an endoscope. Like standard colonoscopy, virtual colonoscopy requires a bowel preparation to cleanse the colon and the insertion of a device into the rectum. While sedation is routinely used to reduce or eliminate discomfort associated with standard colonoscopy, patients are not sedated for virtual colonoscopy. Unlike standard colonoscopy, virtual colonoscopy only provides images of the colon and does not allow for biopsy or polyp removal at the time of the exam. Some abnormalities detected during virtual colonoscopy will require standard colonoscopy for confirmation and management.
Virtual colonoscopy may be indicated in patients with obstructing colon cancer and in patients who have had incomplete colonoscopy. However, there is insufficient evidence to support the use of virtual colonoscopy for the evaluation of patients with symptoms related to the lower digestive tract or for routine colon cancer screening. While the recent New England Journal of Medicine article from the group at Walter Reed Medical Center provides encouraging findings, it should be recognized that these results were obtained in a research setting and may not be replicable in the community environment.(v)
Standard colonoscopy has been proven effective for the detection of colon cancer and pre-cancerous polyps. Moreover, in the National Polyp Study, periodic colonoscopy with removal of polyps was demonstrated to prevent death due to colorectal cancer. This benefit has not been demonstrated for virtual colonoscopy. Therefore, the American Cancer Society, the U.S. Multi-Society Task Force on Colorectal Cancer, and the U.S. Preventive Services Task Force have not recommended virtual colonoscopy for colorectal cancer screening or surveillance.
"Advertisements for total body scanning and virtual colonoscopy may promote potential benefits that have not been documented by clinical studies," said Dr. Ginsberg, who chairs the ASGE Technology Committee. He added, "Patients who undergo virtual colonoscopy may expose themselves to false-negative and false-positive results leading to additional testing, and to unnecessary expense and radiation exposure."
If you are concerned about digestive tract symptoms or if you have questions about colon cancer or colon cancer prevention, contact a physician member of the American Society for Gastrointestinal Endoscopy. Members of the ASGE are trained specialists in performing colonoscopies and other endoscopic procedures.
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