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Virtual Colonoscopy Followed by Optical Colonoscopy Offers Convenience and Therapeutic Benefit

Team Approach Allows Patients to Complete Cancer Screening in Single Day

PHILADELPHIA, PA (September 12, 2008) — Fox Chase Cancer Center is among the first cancer centers in the nation to offer a unique team approach for colon cancer screening by providing virtual colonoscopy which may be followed by conventional (optical) colonoscopy when needed in selected cases.

CT colonography, more commonly called virtual colonoscopy, allows an examination of the large intestine with the use of a low dose CT or “cat” scan.  As with conventional colonoscopy, patients having a virtual colonoscopy require a cathartic bowel preparation the day before the procedure. When the CT scan is complete, a specially-trained radiologist looks for polyps that have the potential to develop into colon cancer.  Since virtual colonoscopy does not require intravenous sedation once the exam is over there are no restrictions on activity or driving.

If suspicious polyps are found, patients are advised to undergo a conventional colonoscopy to allow for the removal of the polyps, a critical step that can prevent the development of cancer. In most circumstances, this colonoscopy can be provided by a Fox Chase gastroenterologist on the same day.

“Instead of sending the patient away and asking them to schedule the second procedure at a later date which would require a repeat bowel prep, Fox Chase offers the opportunity to undergo a conventional colonoscopy on the same day,” says Kristin Edwards, MD, a Fox Chase radiologist conducting CT colonography.  “This eliminates the need for the patient to take another day off from work or find transportation for the second appointment, in addition to avoiding a second bowel prep.”

As with virtual colonoscopy, patients who require conventional colonoscopy complete a cathartic bowel prep before the procedure (unless done prior to the virtual colonoscopy on the same day).  The gastroenterologist uses a colonoscope, a slender tube with a camera at its end, to allow a visual inspection of the colon.  Unlike a virtual colonoscopy, the conventional procedure enables physicians to remove polyps or biopsy areas of the colon wall that look suspicious by using tiny forceps passed through the colonoscope.  The removal of polyps prevents the development of most colon cancers which can arise from the polyps.

Earlier this year, the American Cancer Society added virtual colonoscopy to its list of accepted screening tests for colon cancer, but recognizes that optical colonoscopy is required for cancer prevention through polyp removal.

“Optical colonoscopy is still the gold standard test that allows us to prevent colon cancer by removing polyps,” says David Weinberg, MD, M.Sc, chairman of the Department of Medicine at Fox Chase and a gastroenterologist.  “By offering virtual colonoscopy, we hope to reach people who otherwise may not have received any testing for colon cancer.  The number one goal in cancer prevention is to undergo some sort of screening.”

General colon cancer screening guidelines advise men and women to undergo their first colonoscopy at age 50.  People at higher risk of developing colon cancer because of a personal or family history of cancer should check with their doctors about starting cancer screening at a younger age.

At present, CT colonography for screening purposes is not routinely covered by insurance, whereas a screening optical colonoscopy is.  Generally, insurance does cover a CT colonography if the evaluation is being performed because of symptoms (weight loss, abdominal pain, constipation, bleeding, pre-operative evaluation), and is therefore a diagnostic exam.

“We expect insurance coverage for CT colonography to expand to cover screening exams but for the time being it only covers symptomatic patients for whom the risk of optical colonoscopy or sedation is high because of pulmonary disorders or because the patient is on medication for anticoagulation,” adds Edwards.  “Currently, insurance also covers CT colonography that follows an incomplete optical colonoscopy in patients with symptoms.”

To learn more about virtual colonoscopy, or CT colonography, call Fox Chase Cancer Center at 1-888 FOX CHASE.

Fox Chase Cancer Center, part of the Temple University Health System, is one of the leading cancer research and treatment centers in the United States. Founded in 1904 in Philadelphia as one of the nation’s first cancer hospitals, Fox Chase was also among the first institutions to be designated a National Cancer Institute Comprehensive Cancer Center in 1974. Fox Chase researchers have won the highest awards in their fields, including two Nobel Prizes. Fox Chase physicians are also routinely recognized in national rankings, and the Center’s nursing program has received the Magnet recognition for excellence four consecutive times. Today, Fox Chase conducts a broad array of nationally competitive basic, translational, and clinical research, with special programs in cancer prevention, detection, survivorship, and community outreach.  For more information, call 1-888-FOX CHASE or (1-888-369-2427).

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