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Archive for the ‘Colonoscopy’ Category

Have an overview, how computed tomography is viable for bowel/colorectal cancer!

 

In Computed tomography, as we know, X-rays are used to scan body organs/tissues, where a computer unit is employed for cross-sectional image (slice) construction. The technology is feasible for a variety of medical conditions; in case of patients with cancer/colorectal polyps, CT colonography (virtual colonoscopy) is a practicable approach over traditional colonoscopy procedure, for the diagnosis.

Colonoscopy (endoscopic procedure) is commonly used to visualize interior of the colon/large intestine for irregular growths, tissue inflammation, bleeding and ulcers. The large bowel cancer includes cancerous growth on colon, rectum/alimentary canal, appendix; in the U.S., death rate due to colon/colorectal cancer is high, in contrast to other medical conditions.

For patients suspected of cancer/polyps in the large intestine, computed tomography colonography is a feasible approach for early-stage detection of such, so that the tumor could be taken out, prior it develops further.

People that have a family history, or at increased risk of colorectal cancer (malignant disorder) are proposed for an early scan; men and women, 50+ years are even suggested to go for colon cancer/polyps screening, taking expert consultation.

Various medical groups/associations suggest individuals for – CT colonography once in every 5 years, and colonoscopy in every 10 years.

Stay tuned with MedicExchange, for various health related blogs and stories, from the radiology community, and related!

To stir you up with an astonishing fact about colorectal cancer that has a staggering death rate by way of 655,000 human livestock globally, every year, you at the present would be keen to walk around the syndrome (colorectal cancer) to know it better, to conquer death, god forbid, if you get to pass one.

Colorectal cancer, even recognized by bowel cancer may not be a new term for many that are suffering from one, or otherwise. For the tenderfoot, this sort of disease shows up cancerous growths in the appendix, colon, and rectum in human beings.

Talking about the death rate, the United States of America is on the chartbuster (negatively quoting) that has maximum number of people suffering from colorectal cancer (fourth widespread form of cancer in the USA).

Colorectal cancers come up from adenomatous polyps in the colon that build up into cancer over a point in time, and restricted colon cancer is typically analyzed in the course of colonoscopy.

The death rate in the United States of America, due to colorectal cancer is to thank ‘inadequate screening’ in marginal communities, predominantly those that are deficient of healthcare insurance. More to that, a new healthcare insurance bill has been passed by the assembly where the demand for colorectal cancer along with Mammography will be assisted with.

Many marginal community women in the USA do get mammograms, and talks were on long before of escalating colorectal cancer screening to the women, during mammography visits.

Not long, the Memorial Sloan-Kettering Cancer Center (MSKCC), New York City under the team led by Moshe Shike (MD) proffered colonoscopies to the women that went through mammogram at the Breast Examination Center, Harlem under district outreach agenda of MSKCC, serving out black and Hispanic Harlem community affiliates.

Under the program, the women went through colonoscopy screening (served by MSKCC) all through the year 2003 and 2005, and just about 2,616 women were qualified to go for colonoscopy, then, that fell in the age group of 50 years or so, without any prior colorectal cancer or screening/evaluation history within preceding 10 years.

Of the qualified slot of 2,616 women for colonoscopy, around 77% refused to participate in the study, and only 23% registered for it, at the end.

The investigation team shown the way by Moshe Shike (MD, MSKCC) realized that most of the women that turned down to partake in the study demonstrated immense interest in colorectal cancer screening.

Hence, expanding out colorectal cancer screening during mammography has been instituted to be an effective method for to spawn interest amongst women to initiate the process. The investigating team even realized the fact that the lack of healthcare medical insurance acted as a barricade in the process, and of the 611 women that registered up for the study, only 55% showed up, and went through colonoscopy, and 15% amid the slot had cancerous polyps.

Squashing in again, to let you know that the successive amputation of colon polyps at the time of colonoscopy trims down ensuing risk of colon cancer.

The investigating team after the procedure came to the conclusion of deciding to offer out colorectal cancer screening along with mammography to the deprived and marginal community women at one go.

Here, under both they get to alert women of colorectal cancer, and its treatment, analyzing it through colonoscopy, and Dr. Moshe Shike added further saying that, minority women through this can be referred, screened and arranged for colonoscopy without convening various doctors, and the nurses playing the major role here will facilitate colonoscopy to the women, that come up for mammography at the first place.

On the ground of studies concluded by the team, the need has been cropped up of finding an optional financial source for colorectal cancer screening from the government administration or other private organizations, and as a result of all, let us presume that the colorectal cancer screening to women of deprived marginal community during mammography will surely bring in awareness, and augment screening process in a particular population, that was underprivileged, otherwise.

CT Colonography or Virtual Colonoscopy can detect colonic as well as extra-colonic abdomino-pelvic lesions, an added advantage over colonoscopy.  Virtual colonoscopy uses computerized tomography (CT) to produce hundreds of cross-sectional images of the abdominal organs which are analysed tp produce a veirtual image of the inside of the colon and rectum while colonoscopy is the endoscopic examination of the colon using a colonoscope allowing direct vizualisation of the colon and rectum.

The new findings were reported in the September issue of the American Journal of Roentgenology.

Even though CT colonography (CTC) cannot be compared to CT pelvis and abdomen, the extracolonic findings detected during the procedure can be significant and provides a clear advantage over conventional optical colonoscopy Dr. Ganesh R. Veerappan, MD, of Walter Reed Army Medical Center in Washington and colleagues conducted a retrospective study to analyse the significance of these lesions.

The researchers found that out of the 2277 patients who underwent CTC, about 45 percent cases had extracolonic findings and a quarter of these findings were significant. Further radiology procedures, surgery and follow-up revealed 7 high-risk lesions among the significant lesions and the radiology studies added approximately $50 extra per patient. The virtual colonoscopy examination found six intracolonic malignancies and three adenomas with high-grade dysplasia.

“CT colonography [CTC] not only identifies colorectal cancer [CRC] but also doubles the yield of identifying significant early extracolonic lesions, resulting in lives saved,” Ganesh Veerappan reported in the journal.

The team concluded that the odds of identifying high-risk lesions were raised by 78% with CTC and thus the examination should be considered as an alternative to conventional colonoscopy in colo-ractal cancer screening or as a one-time screening procedure for intracolonic and extra-colonic lesions.

The first national screening programme in Wales came out with the diagnosis of 2.5% higher cases of bowel cancer than it was earlier perceived according to the Western Mail.

A new study published online in March, in the American Journal of Gastroenterology, have found that the hazard of colo-rectal cancer death decreased by 3 percent with every one percent increase in complete colonoscopy rate.

The study included 2,412,077 persons who were men and women aged 50-90 years of age living in Ontario on January. The mean age was 64 years with 53.7 percent of the people included were women, and all the individuals involved in the study had been exposed to different intensities of colonoscopy.

They were followed up for 14 years from January 1st 1993 to December 2006.  Age- and sex-standardized colo-rectal-cancer (CRC) incidence rates were calculated and all CRC deaths were identified. Multivariable cox proportional hazards models were used to evaluate the association between colonoscopy rate and death from CRC, adjusting for age, sex, comorbidity, income, and location of residence (urban/rural).

Colonoscopy, which is the endoscopic examination for the visualization of the colon and distal part of the small intestine and is the gold standard screening test for colorectal cancer and precancerous conditions. It has the advantage that it can also be used in the detection and removal of adenomas and polyps during the same procedure.

With this study, the researchers have attempted to prove that colonoscopy rates is inversely proportional to CRC death rates, that is, as the rate of colonoscopy increases in the population, the CRC death rates decreases.

A study suggests that Virtual colonoscopy or CT colonography can detect malignant cancer outside the colon. According to the study, one out of every 200 people having no symptom of disease possess unsuspected malignant cancer, that too outside the colon.

Colonoscopy is usually done to detect Colorectal cancer, which is supposed to be one of the leading causes of cancer death in U.S. It is recommended to start colorectal cancer screening for people with average risk at the age of 50, but the uneasiness caused by the conventional optical colonoscopy resist people from undergoing screening.

Compared to optical colonoscopy, Virtual colonoscopy has many advantages.

• Less invasive
• Produce detailed image of the interior portion of colon without inserting the scope into it
• The risk of bleeding in the colon, which usually occur with the optical colonoscopy is almost null
• It can be done without sedating the patient
• The structures outside the colon, like pelvis, abdomen and portions of the lungs can be assessed to a limit with this technique. In some cases, virtual colonoscopy is used to diagnose extracolonic parts and most of them appear to be clinically relevant.
• Cost effective
• Saves on time, taking just 10 minutes or less.

The study was conducted by Pickhardt, M.D., professor of radiology and chief of GI Imaging, at the University of Wisconsin School of Medicine & Public Health, and colleagues. For the study, the researchers selected 10,286 adults (5,388 men and 4,898 women) with a mean age of 59.8 years who showed no symptom of the disease. The selected population underwent colorectal cancer screening with virtual colonoscopy either at the University of Wisconsin or at National Naval Medical Center and their medical records were reviewed. It took a mean time 30.2 months for follow-up.

The results showed that 58 patients had unsuspected colorectal cancers, 22 patients had invasive colorectal cancer, extracolonic cancer was found in 36 patients and 31 patients with localized cancers.

Dr. Pickhardt commented,

Although extracolonic evaluation at screening CT colonography does carry some disadvantages, such as patient anxiety, inconvenience, or the potential for benign biopsy, our results suggest that early detection of asymptomatic extracolonic cancer represents an additional benefit of screening CT colonography that is not available with optical colonoscopy. Virtual colonoscopy is an accurate, safe and convenient screening test that could potentially be a life-saving examination.