Virtual colonoscopy reveals diseases outside the colon, as well

at all the solid organs," including the liver, kidneys, pancreas, spleen, gall bladder, adrenal glands, and bladder, plus the lower part of the lungs. In men, the scan includes the prostate; in women, the uterus and ovaries.

"Typically, these are patients who are not symptomatic for their extracolonic lesion; that's not what brought them in for a CT scan," Yee notes. "And they're often at an earlier stage of disease, and thus more amenable to treatment."

Of the 35 patients with significant new extracolonic findings, 25 underwent follow-up imaging studies; of those, 13 were confirmed as needing surgery or further monitoring, and 12 were determined to have benign lesions. Ten of the 35 did not receive any follow-up.

The average additional cost per patient for following up clinically important extracolonic findings was $28.12. "That's relatively low, considering what was found in the patients," says Yee.

The study was conducted on 500 male patients at SFVAMC who were referred for colonoscopy from February 1998 through September 2002. Their mean age was 62.5 years. Thirty-nine percent presented for routine screening and were classified as being at average risk for colon cancer; 61 percent were referred for screening because of one or more symptoms and were considered at high risk for colon cancer.

Patients were followed for an average of three and a half years after screening -- the longest known follow-up in a study of virtual colonoscopy, according to the researchers. There were no significant differences in outcome between average- and high-risk patients. The study did not specifically address findings in the colon; however, in a 2001 study of 300 patients published in Radiology (219:685-692), Yee found that virtual colonoscopy identified every patient with a clinically significant colon polyp.

For Yee, the results of the current study reinforce the potential appeal of virtual colonoscopy for the general public. "

Contact: Steve Tokar
415-221-4810 x5202
University of California - San Francisco

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