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Advantages and Disadvantages of Virtual Colonoscopy

disadvantages of virtual colonoscopy

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The virtual colonoscopy is one of the more recent methods of screening for colonic polyps-precursors to full blown colon cancer. It is a noninvasive test that involves using a CT scan, some oral contrast, and air inflating the colon using a rubber tube in the rectum. The CT scanner uses its computerized mechanisms to visualize colonic polyps to determine whether or not there is a need for a colonoscopy.

Advantages

The major advantage of having a virtual colonoscopy is that it isn't invasive and many people feel more comfortable with noninvasive testing for colon cancer. The alternative is the colonoscopy, which is a test that involves a camera and instrumentation inserted into the colon and run the length of the colon, taking biopsies of suspicious polyps. The colonoscopy is considered the gold standard of colon cancer screening because it is relatively safe and has a 90-95% success rate in picking up cancers or polyps in the colon.

In addition, while both colon tests require preparation, a virtual colonoscopy requires less preparation and the test itself is much more comfortable, with less inconvenience. This is the major reason people give when choosing to have a virtual colonoscopy over a regular colonoscopy.

A virtual colonoscopy is safer than a regular colonoscopy. With regular colonoscopy, there is a risk of perforating the colon, necessitating a hospitalization and IV antibiotics or possible surgery. While with the virtual colonoscopy there is practically no risk. This is another reason some people prefer having a virtual colonoscopy.

Disadvantages

However, there are some disadvantages of virtual colonoscopy. While it can easily detect colonic polyps, it has a success rate of only 85 percent. This is almost 10 percent less successful than having a colonoscopy. It means that some colon polyps might be missed during a virtual colonoscopy. These polyps can be precancerous or cancerous and, if missed, the results can be disastrous. Doctors are getting better at finding polyps on virtual colonoscopy so the success rate may rise in the future.

One of the major disadvantages of virtual colonoscopy is that it can only find pedunculated polyps, which are those on a stalk. This means the test isn't good for picking up flat colon polyps. A regular colonoscopy can find both pedunculated colonic polyps and flat polyps with practically equal ease. Both types can be biopsied by a regular colonoscopy and polyps can be removed by a regular colonoscopy, unlike having a virtual colonoscopy.

So, when one has a virtual colonoscopy and if polyps are found, one will still have to undergo a regular colonoscopy. For those individuals at high risk for colonic polyps or colon cancer, it may not be ideal to have a virtual colonoscopy. The chances of finding polyps with a regular colonoscopy are high, making the virtual colonoscopy superfluous and almost unnecessary. Even people without a history of polyps can have polyps found and could go on to require a regular colonoscopy with additional costs incurred.

In addition, there is X-ray exposure with a CT scan, although it is not much more than having a regular chest X-ray. Some people, however, are concerned about their X-ray exposure and may not choose to have a virtual colonoscopy for this reason.

Costs

As of now, few if any insurance companies will pay for a screening virtual colonoscopy, whereas most will pay for a regular colonoscopy. The cost of a virtual colonoscopy is about $1000-$1200 and must come out of the patient's pocket, creating yet another disadvantage of virtual colonoscopy.

Making the choice of whether to have a virtual colonoscopy versus a regular colonoscopy isn't always easy as there are pros and cons to each procedure. The virtual colonoscopy is safer than a regular colonoscopy but costs a great deal of money out of pocket, doesn't pick up as many polyps as a regular colonoscopy and may necessitate having a regular colonoscopy if polyps are found.

Written by Christine Traxler

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