Does virtual colonoscopy have a major role in population-based screening?
In summary, technical advances in the performance of VC are occurring at a very rapid pace. These technical improvements will undoubtedly improve the polyp detection rate and reduce false-positive and false-negative examinations. The concept of VC is clearly attractive and the general public is enamored with everything that has an association with virtual reality. As other articles in this issue have revealed, there are many techniques in development to help stratify patients at risk for colon cancer. As we begin to focus our health care resources on those at highest risk, the less need there is for inexpensive, broadly based screening techniques. Clearly, those patients at high risk for having polyps are better served by colonoscopy because of its therapeutic potential. That being said, in the view of this author, if a virtual preparation can be achieved and the cost of VC can be kept relatively low, then this technique will become part of our mainstream clinical practice. If an immaculate colon preparation must be performed and if the costs reflect standard abdominal and pelvic CT rather than a special reduced cost for VC, then it is doubtful that there will be any significant impact from this technology
Hawes
Robert H
RH
Digestive Disease Center, Division of Gastroenterology and Hepatology, Medical University of South Carolina, Charleston, USA. hawesr@musc.edu
D003111:Colonic Polyps / Q000175:diagnosis; D023881:Colonography, Computed Tomographic / Q000191:economics; D015179:Colorectal Neoplasms / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D003626:Data Display; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008403:Mass Screening; D010349:Patient Compliance