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Colon testing gets a bit easier

Community Hospital hopes the 20-minute screening will attract patients who are put off by the more invasive traditional method.

MELIA BOWIE
Published September 19, 2003

NEW PORT RICHEY - Hoping that greater comfort will inspire routine checkups, Community Hospital is launching a new and less invasive colonoscopy procedure that officials hope will attract more people for screenings.

Called a "virtual colonoscopy," the method uses computer-assisted X-rays or CT scans to produce a three-dimensional view of the colon in lieu of a conventional colonoscopy where a tube or colonoscope is inserted by a physician.

"It's very good in screening, and the patient's down time is less," said Dr. Guy Barat, a radiologist at Community Hospital.

The entire procedure takes about 20 minutes. No sedation is required and patients can go home immediately, a benefit to those unable or unwilling to undergo traditional treatment.

Officials said they hope less discomfort will inspire people to undergo more routine checkups for cancer and other diseases. Between 70 and 80 percent of people who should have a colonoscopy after turning 50 do not, said Community Hospital staff members.

"They're afraid it's uncomfortable," said Sandy Kyros, imaging marketing manager for the hospital. "You have to be sedated. You miss time off work. There's a lot of excuses why people don't get this done."

No longer, she said.

The FDA first cleared the computer-assisted technology in 1995.

Community Hospital introduced the procedure in March with about 15 test cases. About 25 additional patients have since been screened at the hospital using virtual colonoscopy.

The new technology is intended to examine the colon with greater ease and efficiency - detecting polyps as small as a blueberry as well as cancer or other abnormalities. Because the virtual technique also scans the abdomen, staff at Community even detected a mass in one patient's pelvis - something the conventional treatment does not look for, Kyros said.

However, in many cases, insurance does not cover the virtual treatment - which runs about $600 - in large part because outcome data from large patient groups is not yet available.

The New England Journal of Medicine wrote about virtual colonoscopy in 1999, about the time it was introduced at a number of Boston hospitals and medical schools. The article noted its advantages but also cautioned against its widespread use at the time.

Today, some physicians still question its cost-effectiveness and cite slightly varying interpretations of scan results - electing to wait for technological improvements.

In the meantime, virtual colonoscopy is most often performed in clinical trials designed to establish whether it is an effective cancer screening method.

Physicians at Community Hospital said the lack of insurance coverage could change in time but right now "it's pretty new just like mammography once was. Initially, when they started with it, insurance wouldn't cover it," said Sandy Seibert, director of radiology at Community Hospital.

Conventional colonoscopy, which can cost $1,200 or more, is often covered but requires sedation, a full day of cleansing preparation and a 45 minute exam with a 5-foot-long camera probe. Virtual colonoscopy requires a two-inch insertion of a small tube into the body instead. Small puffs of air fill the colon as computer-assisted technology projects a three-dimensional image of the colon onto a computer screen.

Using a computer mouse, doctors can control the speed of the imaging search and are able to go both forward and backward. Ninety-five percent of the colon or more can be seen instead of the traditional 80 percent.

"Most of the screenings won't find anything," said Denise Aguilera, CT supervisor at Community. If it does, a conventional colonoscopy is needed to treat polyps. If so, she said, the virtual scan has already provided a road map.

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