Does virtual colonoscopy mean less optical?

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With the increasing accessibility of virtual colonoscopy, there has been an ongoing question about whether it might decrease the use of optical colonoscopies for colorectal cancer screenings.

According to researchers at the University of Wisconsin School of Medicine and Public Health, the answer appears to be no.

According to those same researchers, the university in 2004 became the first institution in the U.S. to accept third-party payor coverage for virtual colonoscopy. So now  they have  looked at total colorectal cancer screenings at the hospital between 2003 and 2008 (for patients aged 50 to 75) to see what kind of impact virtual colonoscopy has had on optical colonoscopy.

They found that apparently optical colonoscopy is thriving as a screening tool. During that five-year period the number of screening exams increased 53 percent from 555 per quarter in 2003 to 1,187 in 2008. Optical colonoscopy exams increased from from 555 per quarter in 2003 to 995 per quarter in 2008. At the same time the number of virtual colonoscopies peaked at 307 exams performed in the third quarter of 2005 and declined to 203 performed in the last quarter in 2008.

"Previous theoretical studies showed that once virtual colonoscopies became accepted as a national screen test, regular colonoscopies would be reduced by 25 percent," said Patrick Pfau, MD, associate professor and director of clinical gastroenterology at the University of Wisconsin School of Medicine and Public Health. "But since our virtual colonoscopy program began in 2004, we have seen no change. In fact, we have seen an increase in the number of traditional colonoscopies."

Considering the ongoing controversy surrounding the use of virtual colonoscopy as opposed to optical colonoscopy, further analysis would be useful to determine how representative these results are, and exactly what they mean.

If you have a comment or report to share about how the utilization of advanced visualization technology is changing your practice, please contact me at the address below. I look forward to hearing from you.

Michael Bassett, Associate Editor