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Model predicting colorectal cancer screening suggests higher mortality for virtual colonoscopy

ORLANDO (November 1, 2004) -- Analyses of virtual colonoscopy found both procedure-related mortality and cancer deaths were higher compared to complete (i.e., traditional) colonoscopy, according to findings presented today at the 69th Annual Scientific Meeting of the American College of Gastroenterology (ACG). The analyses, conducted by researchers from Oregon Health and Science University and the Portland VA Medical Center, found that virtual colonoscopy, a test for colorectal cancer that relies on a CT scan of the abdomen and pelvis, carries significant radiation exposure and is less likely to detect cancer or pre-cancerous growths in the colon.

Douglas Faigel, M.D. and colleagues Amnon Sonnenberg, M.D. and David A. Lieberman, M.D. looked at hypothetical cohorts of 100,000 patients undergoing either a single colonoscopy or a virtual colonoscopy at age 60. A key assumption of their decision analysis model is that one-third of patients who undergo virtual colonoscopy will need to have a follow-up colonoscopy.

The Oregon researchers examined complications and deaths per 100,000 patients. "With virtual colonoscopy, we don't avoid the risks of complications from colonoscopy such as bleeding or perforation," explains Dr. Faigel. Rather, the rate of complications for virtual colonoscopy is higher than expected because most of those follow-up colonoscopies are likely to involve the removal of polyps, which increases the likelihood of complications.

Radiation Exposure a Significant Risk

Dr. Faigel warns that virtual colonoscopy exposes normal, healthy people to significant radiation, "A CT scan of the abdomen and pelvis in virtual colonoscopy is a lot of radiation."

For this analysis he and his colleagues assumed a single CT scan of the abdomen and pelvis at age 60 carries the risk of cancer death of 1 in 4,000 and based this assumption on studies looking at cancer deaths among those exposed to
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Contact: Malaika Hilliard
mhilliard@porternovelli.com
202-973-5896
American College of Gastroenterology
1-Nov-2004


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