Journal of Gastroenterology

, Volume 37, Supplement 13, pp 92–96

Colorectal cancer screening: the potential role of virtual colonoscopy

  • John H. Bond


Virtual colonoscopy is a promising new technique that combines rapid spiral CT scanning of the abdomen with advanced computer programs capable of re-creating two- and three-dimensional views of the colon and rectum. Recent studies comparing this method with conventional colonoscopy show that virtual colonoscopy already is more accurate than barium enema X-ray studies for the detection of colorectal polyps, and that it approaches the accuracy of colonoscopy for diagnosing advanced lesions. Before virtual colonoscopy can be promoted for population-based screening for colorectal cancer, a number of issues discussed in this review need to be addressed. These include questions of accuracy, availability, acceptability, and cost-effectiveness.

Key words

virtual colonoscopy colorectal cancer screening 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Guide to clinical preventive services. 2nd ed. Report of the U.S. Preventive Services Task Force. Washington, DC: Department of Health and Human Services, 1995.Google Scholar
  2. 2.
    Winawer SJ, Fletcher RH, Miller L, Godlee F, Stolar MH, Mulrow CD, et al. Colorectal cancer screening: clinical guidelines and rationale. Gastroenterology 1997; 112: 594–642.PubMedCrossRefGoogle Scholar
  3. 3.
    Byers T, Levin B, Rothenberger D, Dodd GD, Smith RA. American Cancer Society guidelines for screening and surveillance for early detection of colorectal polyps and cancer: update 1997. CA-A Cancer J Clin 1997; 47: 154–60.CrossRefGoogle Scholar
  4. 4.
    Rex DK, Rahmani EY, Haseman JH, Lemmel GT, Kaster S, Buckley JS. Relative sensitivity of colonoscopy and barium enema for detection of colorectal cancer in clinical practice. Gastroenterology 1997; 112: 17–23.PubMedCrossRefGoogle Scholar
  5. 5.
    Winawer SJ, Stewart ET, Zauber AG, Bond JH, Ansel H, Waye JD, et al. A comparison of colonoscopy and double-contrast barium enema for surveillance after polypectomy. N Engl J Med 2000; 342: 1766–72.PubMedCrossRefGoogle Scholar
  6. 6.
    Hixson LJ, Fennerty MB, Sampliner RE, Garewal HS. Prospective blinded trial of the colonoscopic miss-rate of large colorectal polyps. Gastrointest Endosc 1991; 37: 125–7.PubMedCrossRefGoogle Scholar
  7. 7.
    Rex DK, Cutler CS, Lemmel GT, Rahmani EY, Clark DW, Helper DJ, et al. Colonoscopic miss rates of adenomas determined by back-to-back colonoscopies. Gastroenterology 1997; 112: 24–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Ahlquist DA, Hara AK, Johnson CD. Computed tomographic colography and virtual colonoscopy. Gastrointest Endosc Clin No Am 1997; 7: 439–52.Google Scholar
  9. 9.
    Hara AK, Johnson CD, Reed JE, Ahlquist DA, Nelson H, Ehman RL, et al. Detection of colorectal adenomas by computed tomographic colography: feasibility of a novel technique. Gastroenterology 1996; 110: 284–90.PubMedCrossRefGoogle Scholar
  10. 10.
    Bond JH. Virtual colonoscopy-promising, but not ready for widespread use. N Engl J Med 1999; 341: 1540–2.PubMedCrossRefGoogle Scholar
  11. 11.
    Rankin GB. Indications, contraindications and complications of colonoscopy. In: Sivak MV, editor. Gastrointestinal endoscopy. Philadelphia: WB Saunders; 1987, p. 873–8.Google Scholar
  12. 12.
    Vining DJ, Teigen EL, Stetts D, Vanderwerken B, Kopecky KK, Rex D. Virtual colonoscopy: a 60-second colon examination. Radiology 1995; 197: 281 (abstract).Google Scholar
  13. 13.
    Fenlon HM, Nunes DP, Schiroy PC 3rd, Barish MA, Clarke PD, et al. A comparison of virtual and conventional colonoscopy for the detection of colorectal polyps. N Engl J Med 1999; 341: 1496–1503.PubMedCrossRefGoogle Scholar
  14. 14.
    Morrin M, Farrell RJ, Kruskal JB, McGee JB. Prospective comparison of virtual CT colonography in patients undergoing elective colonoscopy. Gastroenterology 1999; 116: A461 (abstract).Google Scholar
  15. 15.
    Dachman AH, Kuniyoshi JK, Boyle CM, Samara Y, Hoffmann KR, Rubin DT, Hanan I. CT Colonography with three-dimensional problem solving for detection of colonic polyps. Am J Roentgenol 1998; 171: 989–95.Google Scholar
  16. 16.
    Hara AK, Johnson CD, Reed JE, Ahlquist DA, Nelson H, MacCarty RL, et al. Detection of colorectal polyps with CT colography. Initial assessment of sensitivity and specificity. Radiology 1997; 205: 59–65.PubMedGoogle Scholar
  17. 17.
    Rex DK, Vining D, Kopecky KK. An initial experience with screening for colon polyps using spiral CT with and without CT colography. Gastrointest Endosc 1999; 50: 309–13.PubMedCrossRefGoogle Scholar
  18. 18.
    Miao YM, Paul B, Amin Z, Healy J, Murugan N, Westaby D, et al. A prospective single centre study comparing CT pneumocolon against conventional colonoscopy for detecting colorectal neoplasms. Gastrointest Endosc 2000; 51: AB92 (abstract).Google Scholar
  19. 19.
    Akerkar GA, Hung RK, Yee J, Terdiman JP, McQuaid KR. Virtual colonoscopy: real pain. Gastroenterology 1999; 116: A44 (abstract).Google Scholar
  20. 20.
    Sonnenberg A, Delco F, Bauerfeind P. Is virtual colonoscopy a cost-effective option to screen for colon cancer? Am J Gastroenterol 1999; 94: 2268–74.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2002

Authors and Affiliations

  • John H. Bond
    • 1
    • 2
  1. 1.Gastroenterology Section (111D)VA Medical CenterMinneapolisUSA
  2. 2.University of MinnesotaMinneapolisUSA

Personalised recommendations