The difference was that slightly more than half of the 1,042 Medicare-aged individuals were at increased risk from conventional colonoscopy, due to factors such as anticoagulation therapy (22%), prior incomplete colonoscopy (22%), or chronic obstructive pulmonary disease (COPD) or congestive heart failure (1.5%), according to presenter Lynn Wilson, Joel Fletcher, MD, and colleagues.
Evaluating 2,055 virtual colonoscopy (also known as CT colonography or CTC) exams in all, they found 5.4% of patients with polyps or cancers 1 cm or larger, 8.9% with only polyps 6-9 mm, and 6% of individuals with a clinically significant extracolonic finding that was previously unknown. There were no perforations.
Virtual colonoscopy is a useful adjunct to screening and diagnostic colonoscopy in the Medicare population, Wilson and colleagues concluded, particularly among patients with risk factors for complications at endoscopy.