Virtual Colonoscopy Recommended as Screening Tool for Colorectal Cancer in New Screening Guidelines

joint consensus guidelines for colorectal cancer screening concurred with the latest published research and preliminary results of recently completed trials that support the inclusion of computed tomographic colonography (CTC)--also known as virtual colonoscopy--as a front-line screening exam for colorectal cancer.

The consensus guidelines were released jointly by the American College of Radiology (ACR; Restin, VA, USA), the American Cancer Society (ACS; Atlanta, GA, USA), and the U.S. Multi-Society Task Force on Colorectal Cancer (a group composed of representatives from the American College of Gastroenterology, American Gastroenterological Association, and American Society for Gastrointestinal Endoscopy). CTC now is included as one of several options for colorectal cancer screening and prevention in average-risk adults age 50 years and older, and recommended to be received once every five years.

CT colonography utilizes cutting-edge, virtual reality technology to produce three-dimensional "fly through” images that permit a thorough and minimally invasive evaluation of the entire colorectal structure. No sedation is required for the exam, allowing patients to resume normal activity, including driving, immediately after the procedure.

Since most colon cancers develop from polyps, and screening to find and remove these polyps can prevent colon cancer, an enormous opportunity exists to save lives with early detection. However, in spite of the known benefits of screening, studies indicate that the majority of Americans aged 50 and older are not being screened for the disease.

"CT colonography, as a minimally invasive exam, can potentially encourage many more people to choose to be screened for colorectal cancer. This could result in early detection of the disease for more patients, increasing the chance of successful treatment, and potentially reduce colorectal cancer deaths nationwide,” said Arl Van Moore Jr., M.D., FACR, chair of the ACR Board of Chancellors.

Results of the National CT Colonography Trial, coordinated by the American College of Radiology Imaging Network (ACRIN), suggested that CTC is comparable to optical colonoscopy for the detection of cancer and clinically significant polyps when state-of-the-art techniques are applied and images are read by radiologists trained in the procedure.

To ensure acceptable, consistent levels of performance, quality assurance measures should be implemented by all providers who offer this test. The American College of Radiology has published practice guidelines for CTC, and has outlined practice-based quality metrics.
"Radiologists are undergoing the latest training and education to remain at the cutting edge of this technology. The ACR has taken, and continues to take, steps to standardize the performance and interpretation of this exam nationwide, in order to ensure that patients receive the highest quality care,” said Dr. Moore.

The ACR plans to open an interactive hands-on training facility for CTC and other cutting-edge imaging procedures. A process for individual certification and proficiency is being evaluated. "The ACR urges patients to begin being screened for colorectal cancer at age 50 and we strongly urge Medicare and private insurance companies to support screening efforts by reimbursing appropriately for CT colonography,” said Dr. Moore.

Colorectal cancer is the third most common cancer and second leading cause of cancer death in the United States.

The ACR is a U.S. professional organization serving more than 32,000 diagnostic radiologists, radiation oncologists, interventional radiologists, nuclear medicine physicians, and medical physicists, with programs focusing on the practice of radiology and the delivery of comprehensive healthcare services.


Related Links:
American College of Radiology
American Cancer Society
Multi-Society Task Force on Colorectal Cancer