A Blog for Healthcare Consumers

Colonoscopy is a test that is used to evaluate the colon (aka the large bowel). It is one of many tests that can detect colon cancer and is used to look for the source of bleeding in patients who have blood in their stool. The American Cancer Society has published its colon screening recommendations.

Traditional or conventional colonoscopy uses a flexible scope with a fiberoptic camera to look at the inner surface of the colon. The camera is connected to an external monitor which your GI doctor uses to guide the camera and look for polyps or other lesions. Using a small cutting device at the end of the tube, if any polyps are found, they can be removed and sent to a pathologist to determine if the polyp is benign or cancerous. As this is an invasive procedure, patients are sedated for the test, and there is some risk of injury to the colon from the tube. Also, on occassion, the colonscopy will "fail." That is, the tube is unable to reach the end of the colon because of its length or is blocked by the colon's many turns and folds.

3D or virutal colonoscopy is a relatively new way to evaluate the colon. Instead of using a camera, a CT scanner takes numerous images and creates a 3D model of the inside lining of the colon. A Radiologist interprets the 3D images on a computer workstation and reports the findings to your doctor. Virtual colonscopy can also detect polyps, masses and any irreguarilities in the lining of the colon. However, unlike traditional colonscopy, if any polyps are seen, there is no way to biopsy the polyps directly. Virtual colonoscopy may not detect small polyps though more powerful CT scanners and computer software will likely make this a non-issue in the near future.

Here's a comparison summary:

Virtual Colonscopy:

• Uses a CT scanner
• Takes 30 minutes to do
• No sedation needed
• Not covered by insurance
• Not able to do biopsy
• Radiation exposure
• May miss small polyps

Conventional Colonoscopy

• Uses a flexible tube with a camera
• Takes 1-2 hours to do
• Need to be sedated for test
• Covered by insurance
• Can biopsy polyps
• May not reach end of colon
• Risk of colon puncture
  

So how much do virtual colonscopies cost? Very few insurance plans cover virtual colonoscopies. A recent Wall Street Journal article featuring virtual colonoscopy revealed a wide range in prices among Radiology providers (you'll need a subscription to access the article). Prices varied from $500 to $1500.

Do you know of any other centers in your area that offer this test? We'd be happy to add them to our list of providers. Looking forward to hearing from you. Please leave your comments below.