Author Affiliations: Departments of Medicine and Epidemiology, University of North Carolina, Chapel Hill.
Virtual colonoscopy has been under development for more than a decade,
but only recently has it been reported to have sufficiently high enough sensitivity
(94%) and specificity (96%) for detecting large (≥1 cm) polyps to warrant
serious consideration as an option for colon cancer screening.1 However,
the study by Cotton and colleagues2 in this
issue of THE JOURNAL reports a much lower sensitivity (55%) for this technique.
The results of the previous study by Pickhardt et al1 showed
what the advanced technology, including bowel preparation, software, method
of interpretation, and training, can achieve in ideal
circumstances, whereas the current study by Cotton et al demonstrates what
the technology likely would achieve if implemented
in community practice. In light of such differences in the results of these
2 studies, how should physicians, investigators, policy makers, and payers
address questions of development and implementation of virtual colonoscopy?
Ransohoff DF. Virtual Colonoscopy—What It Can Do vs What It Will Do. JAMA. 2004;291(14):1772-1774. doi:10.1001/jama.291.14.1772