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Surgical Removal of Small Colon Polyps is Costly and Unnecessary
November 04, 2008Polypectomy (the surgical removal of polyps by colonoscopy) of small polyps found during CT colonography is costly and unnecessary according to a study performed at the University of Wisconsin School of Medicine and Public Health in Madison, WI.
A decision analysis model was constructed to represent the clinical and economic consequences of performing three year colorectal cancer surveillance, immediate colonoscopy with polypectomy, or neither on patients who have 6-9 mm polyps found on CT colonography (CTC). The analysis model was accompanied by a hypothetical population of 100,000 60-year-old adults with 6- to 9-mm polyps detected at CTC screening. Results showed that, "by excluding large polyps and masses, CTC screening can place a patient in a very low risk category making colonoscopy for small polyps probably not warranted," said Perry J. Pickhardt, MD, lead author of the study. "Approximately 10,000 colonoscopy referrals would be needed for each theoretical cancer death prevented at a cost of nearly $400,000 per life-year gained. We would also expect an additional 10 perforations and probably one death related to these extra colonoscopies. There may be no net gain in terms of lives-just extra costs," said Dr. Pickhardt.
"The clinical management of small polyps detected at colorectal cancer screening has provoked controversy between radiologists and gastroenterologists. Patients should be allowed to have the choice between immediate colonoscopy and imaging surveillance for one or two isolated small polyps detected at colorectal cancer screening," said Dr. Pickhardt.
CT colonography is now a recommended test for colorectal cancer screening by the American Cancer Society. "If patients with small polyps are monitored, only five percent of adults undergoing CTC screening will need to undergo immediate invasive colonoscopy," said Dr. Pickhardt.
American Roentgen Ray Society
CT colonography is now a recommended test for colorectal cancer screening by the American Cancer Society. "If patients with small polyps are monitored, only five percent of adults undergoing CTC screening will need to undergo immediate invasive colonoscopy," said Dr. Pickhardt.
American Roentgen Ray Society
Colonoscopy Current Events and Colonoscopy News RSSColon cancer screening more effective earlier in day, UCLA study finds
The effectiveness of a screening colonoscopy may depend on the time of day it is performed. According to a new UCLA study, early-morning colonoscopies yielded more polyps per patient than later screenings, and fewer polyps were found hour by hour as the day progressed.
Residents play key role in CT colonography awareness and promoting the radiology specialty
Residents can serve a vital role in educating Congress, the medical community, and the general public regarding the efficacy of cutting-edge technologies like CT colonography (CTC) as well as the importance of radiologists' training and education and the role that radiologists serve in the provision of quality health care.
High-definition Colonoscopy Detects More Polyps, Mayo Clinic Researchers Say
High-definition (HD) colonoscopy is much more sensitive than standard colonoscopy in finding polyps that could morph into cancer, say researchers at the Mayo Clinic campus in Florida.
Study shows unsedated colonoscopy for colorectal cancer screening well accepted by patients
Researchers from Taiwan report in a new study that unsedated colonoscopy for primary colorectal cancer screening is well accepted in a majority of patients.
M. D. Anderson redefines screening guidelines for breast, cervical and colorectal cancers
Drawing on years of experience in cancer research and patient care, The University of Texas M. D. Anderson Cancer Center released today the most comprehensive, risk-based screening guidelines publicly available to date for breast, cervical and colorectal cancers.
How to Lower Costs, Waiting Times for Colonoscopies
Colorectal cancer is a leading cause of cancer-related deaths in the United States, leading to over 50,000 fatalities every year.
New blood tests promise simple, cost-effective diagnosis of gastrointestinal cancers
Promising results from two new blood tests that can aid in the early identification of patients with gastrointestinal (GI) cancers will be presented at Europe's largest cancer congress.
Gut Ecology in Transplant Patients
Small-bowel transplant patients with an ileostomy -- an opening into their small bowel -- have a very different population of bacteria living in their gut than patients whose ileostomy has been closed, researchers from UC Davis and Georgetown University Medical Center have found.
How to increase colonoscopy attendance?
In view of low attendance rate for colonoscopy screening for colorectal cancer (CRC), it is necessary to establish effective intervention methods to increase colonoscopy compliance.
Reinterpretation of proximal colon polyps called hyperplastic in 2001
Serrated colorectal polyps include the subgroups hyperplastic polyps, sessile serrated polyps (also called sessile serrated adenomas), and serrated adenomas.
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