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Method Detects Extracolonic Lesions Over Colonoscopy

Computed tomography with colonography may be more effective and less costly

MONDAY, April 14 (HealthDay News) -- Abdominal computed tomography with colonography (CTC) is more effective and less costly than optical colonoscopy (OC) for the detection of extracolonic findings such as abdominal aortic aneurysms and extracolonic cancers, according to an article in the April 14 issue of the Archives of Internal Medicine.

Cesare Hassan, M.D., from Nuovo Regina Margherita Hospital in Rome, Italy, and colleagues performed computerized simulated screening comparing abdominal CTC and OC, with and without abdominal ultrasonography, to detect colorectal neoplasia, extracolonic cancers and abdominal aortic aneurysms in a hypothetical group of 100,000 patients 50 years of age in the United States. A threshold polyp size of 6 mm was used.

The researchers found that CTC was more effective and less costly than OC either with or without ultrasonography. CTC was associated with 1,458 and 462 additional life-years and a savings of $266 and $449 per person compared with OC and OC with ultrasonography, respectively. Most of the gains for CTC were due to a reduction in deaths due to abdominal aortic aneurysms. OC with ultrasonography became more cost-effective with reduced sensitivity of CTC for large polyps or broad variations in CTC or OC cost.

"The model is based on several optimistic assumptions that tend to support the value of finding extracolonic lesions," Robert H. Fletcher, M.D., and Michael Pignone, M.D., from Harvard Medical School in Boston, write in an accompanying editorial. "Results of the present study are more favorable than other cost-effectiveness models, which have generally found CTC to be less cost-effective than colonoscopy."

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