Virtual colonoscopy tops conventional screening

The removal of lesions 6 mm or greater found by CT colonography screening is more cost-effective, safer, and just as clinically effective as colonoscopy or flexible sigmoidoscopy, according to a study in the June 1 issue of Cancer.

Dr. Perry Pickhardt, an associate professor of radiology at the University of Wisconsin, and Dr. Cesare Hassan, a gastroenterologist in Rome, collaborated on the analysis. Their findings contradict previous ones showing that colonoscopy and flexible sigmoidoscopy of all sizes of polyps are more cost-effective than CT colonography. Earlier studies, however, ignored CT colonography guidelines on reporting only polyps greater than 5 mm. The cost per life-year gained from CT screening with a 6-mm threshold for follow-up was $4361 compared with $9180 for colonoscopy. The cost per life-year gained with CT screening with no polyp size threshold was $7138, compared with $7407 for flexible sigmoidoscopy.