New Screening Tool Adds to the Offerings for Colon Cancer Screening

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It is estimated that 150,000 new cases of colon cancer will be detected in the United States this year. According to the American Cancer Society, about 90% of these cases could be prevented with early screening, but less than 50% of the population is getting tested. March is designated as National Colorectal Cancer Awareness Month to encourage Americans to get appropriate screening for the second leading cause of cancer death in the US.

Colorectal cancer is a malignancy of the large intestine or the rectum. If undetected, it can break off and spread to other parts of the body, most frequently the liver. Most colorectal cancers give no warning signs until they are well advanced, so physicians recommend universal screening, usually started at age 50. Higher risk patients, such as African-Americans, those with a family history of the disease, and patients with Crohn’s disease, should be tested earlier.

The most comprehensive and preferred screening method for the detection of colon cancer is the colonoscopy. Doctors believe that all colon cancer starts off as benign polyps, so by getting tested early, one may be able to completely prevent the polyps from becoming malignant. During a colonoscopy, a flexible, slender tube is inserted through the rectum, allowing the doctor to view the entire colon. It is a safe and painless procedure that lasts approximately 20 minutes in most cases. Should a polyp be found, it can be removed at the same time as the screening test and biopsied to determine if it is cancerous or not.

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One of the reasons for the low screening compliance rate is a fear of the colonoscopy procedure and the anesthesia used. A newer form of technology is increasingly becoming an alternative for the standard colonoscopy for low-risk patients. The CT colonoscopy, or virtual colonoscopy, does not replace a colonoscopy for care, but offers patients a non-invasive form of screening. In fact, President Obama just underwent a virtual colonoscopy procedure at the National Naval Medical Center in Bethesda, MD.

The procedure takes only a few minutes and does not require patient sedation. The two quick CT scans reconstruct a 3D visual image of the colon to identify the presence of polyps. The American Cancer Society and the American Medical Association support the virtual colonoscopy for front-line screening.

However, unlike the standard colonoscopy, it cannot remove the tumor at the same time, so a patient would have to undergo a second procedure if polyps are found. In addition, the Centers for Medicare and Medicaid Services (CMS) have denied reimbursement for the exam, stating there was not enough benefit for their patients, who are often 65 and therefore placed in a higher risk category.

Screening for colon cancer has reduced the incidence of the disease by 22%, according to a study conducted by the American Cancer Society, the National Cancer Institute, the Centers for Disease Control and Prevention, and the North American Association of Central Cancer Registries.

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