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PubMed · 12362486

[Virtual colonoscopy].

Abstract

Colorectal cancer is a leading cause of cancer death in the western world. Virtual colonoscopy is a new method for 2-D and 3-D imaging of the colon, using a multislice helical CT technology. This method has already demonstrated excellent results in polyp and cancer detection, having similar accuracy to endoscopic colonoscopy in the detection of polyps above 6 mm in size. The major application of this novel technique is in diagnosing cases where conventional colonoscopy fails to demonstrate the entire colon due to technical problems. The second important application is to investigate the colon proximal to an obstructing tumor, where both barium enema and colonoscopy cannot overcome the obstruction. The possibility of widespread application remains in evaluating the use of virtual colonoscopy in a purely screening population. Further developments, including stool tagging, computer aided detection of polyps and faster scanners will contribute to accuracy and patient compliance with widespread use of virtual colonoscopy. This examination may dramatically improve population participation in screening programs and play a major role in minimizing the impact of colorectal cancer.

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BibTeXRIS

Elisha Barmeir. 2002. [Virtual colonoscopy].. https://pubmed.ncbi.nlm.nih.gov/12362486/

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Effect of hysterectomy status on polyp detection rates at screening flexible sigmoidoscopy.

BACKGROUND: Flexible sigmoidoscopy with polypectomy reduces the incidence of colorectal cancer by removal of premalignant lesions. Factors that reduce the area examined by flexible sigmoidoscopy may reduce its benefit. The aim of this study was to determine whether hysterectomy affects completion and polyp detection rates at flexible sigmoidoscopy. METHODS: Within the setting of a multicenter, prospective, controlled trial of screening flexible sigmoidoscopy, patient and examination variables were compared by appropriate statistical methods for women between the ages of 55 and 64 years with and without a history of a hysterectomy. RESULTS: One quarter of women participants had undergone a hysterectomy. These women were more likely to have incomplete examinations (risk ratio [RR] of incomplete examination, 1.53; 95% CI [1.4, 1.6]). Flexible sigmoidoscopy was more difficult (p < 0.001), more painful (p < 0.001), and less extensive (46 cm vs. 48 cm insertion on average; p < 0.0001) in women who had undergone a hysterectomy. There was a significant trend toward lower relative detection rates of polyps and adenomas at more proximal sites (rectum, sigmoid colon, and proximal to sigmoid; respectively, p = 0.008, p = 0.009) in this group. CONCLUSIONS: Women who have undergone a hysterectomy have less extensive flexible sigmoidoscopy examinations, which are more difficult and more painful, than women without a hysterectomy. Hysterectomy is associated with a reduction in polyp detection rate in the sigmoid colon. This modality of screening may be less effective in women who have undergone a hysterectomy.

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