Colonoscopy Remains Most Accurate Technique For Detecting Colon Polyps and Cancer

OAK BROOK, Ill. -- Spokespersons for the American Society for Gastrointestinal Endoscopy (ASGE) have commented on the recent multi-center study under the leadership of Duke University Medical Center researchers and published in the Jan. 1, 2005 issue of The Lancet.  The study shows dramatic evidence that colonoscopy is still the most accurate method for screening for colon cancer.

In direct comparisons on 614 patients at risk for colon cancer, the study

tested the relative sensitivity of the two widely used techniques for

detecting colon cancer -- 1) air-contrast barium enema (ACBE) and 2)

colonoscopy -- with a newer non-invasive technique called 3) computed

tomographic colonography (CTC).  (See descriptions below.)  Colonoscopy was by

far the most reliable for detecting both large and smaller colon polyps.

Colorectal cancer is the third most commonly diagnosed cancer in men and

women and the second leading cause of cancer-related deaths in the United

States and Western Europe.  The lifetime risk of developing this cancer is

approximately 6 percent of the adult U.S. population and almost half will die as a

consequence.  Early detection can save lives, so screening is crucial.

According to David J. Bjorkman, MD, president of the ASGE and dean of the

University of Utah School of Medicine, "This research reaffirms that colonoscopy remains the gold standard for screening patients for colon cancer.  In the study, colonoscopy detected virtually all (98 percent) of larger polyps and (99 percent) of smaller lesions.  Compared to the other two screening methods, colonoscopy was 39 percent more accurate than CTC and 51 percent more accurate than ACBE in detecting larger lesions (10 mm +) and 51 percent more accurate than CTC and 64 percent more accurate than ACBE in detecting smaller lesions (6mm to 9 mm)."

"Colonoscopy is still the most accurate test for detection and removal of

cancer and pre-cancerous growths in the colon,” says David Lieberman, MD, of the Oregon Health Sciences University, Portland VA Medical Center, Portland, OR, and past president of ASGE. “Like any medical test, colonoscopy is not perfect, and some polyps may be present, but not detected. However, most pre-cancerous polyps and virtually all cancers will be detected, and can usually be removed during the colonoscopy examination."

Three Methods of Colon Cancer Screening Compared in the Duke University Medical Center Study:

1.  Air-contrast barium enema (ACBE) -- A small volume of liquid barium is

introduced into the colon, which is then distended with air, coating the

surface of the colon with a thin layer of agent to permit an X-ray study to

review for any abnormalities.

    2.  Colonoscopy -- A long, thin, flexible tube containing a color video

camera (endoscope) is inserted into the digestive tract, which provides close-

up video images of the patient's digestive system.  It also has devices to

collect sample tissues, stop bleeding and remove polyps during the same

procedure.

    3.  Computed tomography colonography (CTC) -- A CT scan is used to create

computer-generated images of the colon to inspect for polyps.

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