Friday, October 27, 2006

GI Docs Not On Virtual Colonoscopy Bandwagon

Filed under: GI , Radiology

V is for VirtualGI doctors are urging (gasp!) caution before adopting a new patient favorite, virtual colonoscopy. It seems this noninvasive imaging technique might pick up too many abnormalities (especially outside the gut), prompting wild goose chases for incidentalomas, racking up bills and possibly endangering patients down the road (not to mention, GI docs who would lose revenue to radiologists) . But hey, what is Virtual Colonoscopy, anyway?

It allows doctors to use CT scanners to look at the colon to detect polyps (small growths in the colon that may become cancerous if they are not removed) and cancers. Virtual reality software allows them to look inside the body without having to insert a long tube (conventional colonoscopy) into the colon or without having to fill the colon with liquid barium (barium enema).

Research performed at Wake Forest Baptist and elsewhere has shown that CTC is better able to see polyps than barium enemas and is nearly as accurate as conventional colonoscopy. Most patients report that CTC is more comfortable than either procedure.

"Virtual colonoscopy will certainly play a role in the future of colon cancer screening," said gastroenterologist Richard S. Bloomfeld, M.S., M.D., assistant professor of medicine at Wake Forest Baptist and a member of the research team. "It is important to understand the implications of findings outside the colon before we advocate wide-spread use of this technology."

He's right, of course, but we can't help but read between the lines: "Please, please, give me a few more years to coast, before I'm forced to hand over all my income from diagnostic colonoscopies to the radiologists..."

Press release from Wake Forest...

Flashback: Virtual Colonoscopy As Good As Regular Roto-Rooter

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replies: 2 comments
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The drawbacks of virtual colonoscopy go far beyond "incidentalomas":

-A prep, which is what people dislike most about colonoscopy, is still required.
-In most studies where patients undergo both procedures, patients find virtual colonoscopy more uncomfortable (due to air insufflation) than colonoscopy.
-Radiation exposure.
-More expensive and less cost-effective.
-Highly variable detection rates.


Posted by: ee
on October 28, 2006 11:03 AM GMT

I'm quite surprised by the comment that the virtual colonoscopies are more comfortable. I found my own colonoscopy to be a fairly dull affair, the preparation is the more annoying part of the process. ( I also wonder whether my own procedure would have just ended up with a real colonoscopy afterwards, since I did have polypectomies during the procedure.)


Posted by: Joe
on December 17, 2006 11:14 PM GMT