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Total colorectal cancer exams increased after initiation of virtual colonoscopy screening
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2010 Digestive Disease Week
NEW ORLEANS — The initiation of a CT colonoscopy screening program did not reduce the number of traditional optical colonoscopies, researchers at the University of Wisconsin have concluded.
Instead, Patrick Pfau, MD, associate professor and director of clinical gastroenterology at the University of Wisconsin School of Medicine and Public Health, said the number of optical colonoscopies performed has increased.
“The number of virtual colonoscopies ordered took off right away in 2004 and 2005,” Pfau said. “The number of virtual colonoscopies ordered since then has actually decreased from 2006 to 2009.”
Pfau discussed the results Tuesday during a press conference at the 2010 Digestive Disease Week. These findings are an update of two-year results presented at Digestive Disease Week in 2007.
Pfau presented the results of the study to determine the five-year effect of CT colonography screening, also known as virtual colonoscopy, on the number of screening, therapeutic and total optical colonoscopy exams performed. The University of Wisconsin is one of the few health care systems where private insurance payors cover CT colonography screening.
Researchers compared the mean numbers of screening, therapeutic and total optical colonoscopies performed per quarter in 2003, when open-access insurer coverage for CT colonography was introduced, with those performed in 2008.
The peak number of CT colonographies performed per quarter was 307, observed in the third quarter of 2005. That number decreased to 203 in the last quarter of 2008.
In contrast, the number of screening optical colonoscopies performed increased from a mean of 555 per quarter in 2003 to a mean of 995 per quarter in 2008. Researchers said the mean per quarter number of total optical colonoscopies exams performed increased from 1,104 in 2003 to 1,976 in 2008.
The mean number of per quarter therapeutic colonoscopies remained constant from 463 in 2003 to 490 in 2009. The number of total colorectal cancer screening exams increased significantly from 555 per quarter in 2003 to 1,187 in 2008.
Five years after initiation of a virtual colonoscopy screening program, a mean of 1,255 quarterly screening exams were performed; 86.6% of patients were screened with optical colonoscopy and 8.5% were screened with CT colonography.
“After five years, virtual colonoscopy had no impact whatsoever on endoscopic screening,” Pfau said. “However, overall, the number of cases screened by combined endoscopic plus virtual colonoscopy has gone up two-and-a-half times.” – by Jason Harris
Referring patterns have not changed. If we find something on colonoscopy, we can deal with it right there. If we find something on virtual colonoscopy, it requires a second visit and second day off of work, etc. Regular physicians have figured that out. That is why the number of virtual colonoscopies has not shot up and the number of colonoscopies has not plummeted.
– John Carethers, MD
Chair, Internal
Medicine, University of Michigan Medical School
For more information:
- Benson ME. #683a. Impact of a CT Colonography Colorectal Cancer Screening Program on Optical Colonoscopy: 5-Year Data. Presented at: the 2010 Digestive Disease Week; May 1-6, 2010; New Orleans.
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