There’s no question, early screening for colon cancer saves lives, particularly among those aged 50 and older. But there is a debate now among medical experts: can patients get as good, and as safe a reading by using virtual colonoscopy, which uses x-ray images, or must they still go for a standard colonoscopy which uses a scope to look into the colon?

In spite of the fact a recent major study shows virtual colonoscopy is as effective as standard colonoscopy, this new analyses found that both procedure-related mortality and cancer deaths were higher in virtual colonoscopy, compared to traditional colonoscopy.
Virtual colonoscopy relies on a CAT scan of the abdomen and pelvis.
Dr. Marc Sapienza, a gastroenterologist at Englewood Hospital, says, “It’s not a real video appearance but a computer generated one. The advantage with virtual colonoscopy is that it can be used to scan patients who cannot tolerate the sedation required for traditional colonoscopy.”
However, new research shows that virtual colonoscopy carries significant radiation exposure, and is less likely to detect cancer or pre-cancerous growths in the colon. The study didn’t examine specific patients per se, but set up a hypothetical model, presuming one-third of patients getting virtual colonoscopy would have unclear findings and need to go for standard colonoscopy.
The rate of complications for virtual colonoscopy was higher than expected because most of those follow-up colonoscopies are likely to involve the removal of polyps, which increases the likelihood of complications.
“The findings of the study were actually surprising. The results actually indicated that the procedure related mortality was higher after virtual colonoscopy than after traditional colonoscopy,” Dr. Sapienza says.
They also presumed there would be more cancer related deaths due to missed diagnoses with virtual colonoscopy.
The four largest studies of virtual colonoscopy have been published in the last year, and three of the four studies showed very poor results for virtual colonoscopy compared to traditional colonoscopy. Only one showed results for virtual colonoscopy comparable to traditional colonoscopy.
“Virtual colonoscopy is extremely useful for patients who cannot undergo sedation, but the caveat for this is that virtual colonoscopy is indicated only in patients who are considered low to average risk patients,” states Dr. Sapienza.
No guideline group has yet endorsed virtual colonoscopy for colorectal cancer screening. Standard colonoscopy remains the most sensitive test available for detection of colorectal polyps and cancer. You should discuss with your doctor about which screening method you should choose.
According to the American College of Gastroenterology, patients 50 and older should have standard colonoscopy at least once every ten years. Those undergoing colonoscopy should identify doctors who have substantial experience, having performed large numbers of endoscopies.

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