CT Colonography: A Noninvasive Colorectal Cancer Screening Option
Computerized tomographic colonography (CTC), also known as virtual colonoscopy, can be adopted into clinical practice as another screening option for colorectal cancer the nation's second-leading cause of cancer death.
The National CT Colonography Trial, results of which were published in the September 18 issue of the New England Journal of Medicine demonstrated that CTC is highly accurate for the detection of intermediate and large polyps, which are the ones more likely to develop into cancer. Over 2,600 participants age 50 years or older who did not have symptoms of colorectal disease underwent both conventional and virtual colonoscopies on the same day. Using conventional colonoscopy as the gold standard, the study revealed that CTC detected polyps 10 mm or larger in 90 percent of all participants who were also confirmed to have a polyp of this size by conventional colonoscopy. In addition, CTC is able to reliably detect polyps as small as 5 mm in width (about the diameter of a pencil) with high sensitivity.
The wide adoption of virtual colonoscopy will encourage more people to be screened due to its accuracy, safety, cost- & time- effectiveness, and patient acceptability. "Based on the results of this study, we hope that this less invasive option for screening for colorectal cancer will help more people to get screened for colorectal cancer, which would result in fewer deaths," said Dr. Peter Zimmerman, co-principal study investigator along with Dr. David Lu at UCLA.
UCLA's excellent study team, coordinated by Drs. Ferdnand Osuagwu and Wanda Marfori, enrolled a large number of patients into this national trial. One of the strengths of this trial compared to several previous trials which had shown mixed results, is that only institutions with radiologists adequately trained and experienced in CTC participated in the current study.
"We hope that CT colonography will reduce the number of deaths from colorectal cancer by providing an effective screening that is safe, cost-effective, and more comfortable to patients than current methods. ” — Dr. Peter Zimmerman, Co-principal Study Investigator, Lead Investigator @ UCLA Site
Michael Douek, MD
Barbara Kadell, MD
David Lu, MD
Daniel Margolis, MD
Steve Raman, MD
Jimmie Wong, MD