Colon cancer screening now can go noninvasive route

Virtual colonoscopies already are proving an effective cancer screening technique for some patients, but polyp removal still requires conventional means.

By Susan J. Landers, AMNews staff. Sept. 15, 2003.

Washington -- No one considers a colonoscopy to be pleasant. Even physicians who recommend the screening procedure for others have been known to postpone it when they are the patients.

That's why it's hardly a surprise that a virtual version of the test is attracting attention.

Although conventional colonoscopies are the current gold standard for colon cancer screening, they aren't going to be effective if people avoid them.

"Less than half of the individuals who should be screened for colon cancer are screened appropriately," said Matthew Barish, MD, director of the 3D and Image Processing Center at Brigham and Women's Hospital in Boston. "A large number of people do not undergo screening because they look at it as uncomfortable or embarrassing."

As a result, many physicians are exploring virtual colonoscopies as a way to substantially boost the numbers of patients willing to undergo the life-saving procedure.

Virtual colonoscopy is an imaging technique of the large bowel or colon using CT or MRI scans. A full cleansing prep is required, but the procedure does not require sedation. The scans are being recommended for individuals at risk for colon cancer but for whom sedation, required of conventional colonoscopy, poses a risk. They also are recommended for those few whose bowels contain an obstruction that blocks passage of the tube used in conventional colonoscopies.

Most agree it is important to get people screened. After all, colon cancer is the second most common cause of cancer deaths in the nation. The disease often begins as malignant cells that form in slow-growing polyps attached to the inner surface of the bowel. Removing the polyps early is an effective means of prevention.