CT Colonography Finds Tumors Outside Colon

With the FDA planning to hear public comments on radiation levels next week, potential good tidings come from a study with CT colonography and the unsuspected malignancies it found.

The procedure showed early stage tumors, more than 50% of them outside the colon, in more than one asymptomatic person among 200. Besides the 58 patients showing unsuspected cancer, 22 showed invasive colorectal cancer and 36 others had, among others, kidney and lung cancer and non-Hodgkin lymphoma.  More than half of their tumors were early stage as well. The study included 10,286 men and women with an average age of 60. All of them had had CT scans at the two main US facilities currently offering them. The Naval Medical Center, in Bethesda, Maryland, is one of those and provided a CT colonography to President Obama recently.

This “is more of a comprehensive screening test that is not simply limited to the colon but can find important and unsuspected things outside of the colon at an earlier and presumably curable stage,” said study author Perry J. Pickhardt, MD, professor of radiology at the University of Wisconsin School of Medicine and Public Health in Madison, as quoted in BusinessWeek.com, which sourced an article in the April issue of Radiology. “The net benefit of that extra component is a pretty significant advantage for a test that is overall safer and cheaper and more convenient [than conventional colonoscopy].”

While the debate continues about whether or not CT colonography will be covered by Medicare or Medicaid, the American Cancer Society already recommends it for average risk patients. It isn’t a panacea, researchers agree, as it doesn’t always accurately predict cancers after positive FOBTs, and it can produce false positives, requiring even more radiation for further determination.

Patients, naturally, might prefer a colonography to a much more invasive colonoscopy, though the CT variety does still require colon cleansing. But “some of the advantages of the virtual colonoscopy is that there’s no IV, no medication, no sedation or recovery time. You also get a look outside the colon because it does 3-D fly-throughs [of the abdomen],” Dr. Pickhardt said.

Related seminar: CT/MRI of the Abdomen and Pelvis