Tuesday, March 20, 2007
New Innovations in Colonoscopy
Colonoscopy, the screening scope test that looks for polyps and cancers in the large bowel, may be replaced with new methods for diagnosing colon cancer. We've all been waiting for a new technology that will eliminate the awful cleansing prep the day before, the IV sedation and the hassle of spending an entire day undergoing an expensive screening test for colon cancer.
Yes, screening colonoscopy is a great way to find polyps and growths before they become invasive cancer. Yes, it is relatively safe and effective but, jeeze, what a hassle. And for a screening test, it is quite expensive, therefore millions of uninsured and underinsured people just don't get screened at all.
On the horizon is virtual colonoscopy, a high-resolution CT scan with a software program that allows you to recreate or simulate the colon. This computer-aided diagnosis will shorten the time frame and allow more screenings to be done. Currently you can get a virtual test but the prep remains the same. Soon "prepless" CT scans will eliminate the need to cleanse the colon and most patients will embrace this. Another promising alternative that is being developed is the PillCam which is a capsule with cameras that are inserted or swallowed and project images as the pill passes through the bowel. We currently have endoscopy capsule technology that images the small bowel and the new pill would have double cameras that cover twice as much area as most of the small bowel capsules. We have a way to go with this technology but given its simplicity and the rate of innovation, this may be the wave of the future.
At this point, good old fashioned scope colonoscopy remains the gold standard and in a person with no risk factors (family history of colon cancer, crohns disease or unusual bleeding), screening should begin at age 50 and every 10 years thereafter. If you are 50, go ahead and get that colonoscopy. If all goes well, with the current rate of new technology being developed, it may be the last one you need to get.
Posted by Toni Brayer, MD at 11:06 PM