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Sunday, July 19, 2009

High Tech Colon Assessment

Can Your Colon be Examined with a Pill?

Most of us know the recommendation by now: If you're at average risk for colon cancer, once you reach the age of fifty you should have a colonoscopy to screen for the disease, as well as precancerous lesions called polyps. But who wants to undergo this test? It's even less fun than mammography (an issue I can speak to), requires a day of preparation where it's almost impossible to leave the house, sedation and the need for a driver to provide transport home. Jokes abound about screening colonoscopy, and Katie Couric's courage notwithstanding, the majority of those eligible for screening choose not to have it.

So would the test be more acceptable if it just involved swallowing a pill, albeit a pretty big one? The PillCam measures 31 by 11 millimeters. (Read the fine print: bowel preparation still required.) This test merely requires swallowing the device, pictured above, and continuing to drink the same solution used to cleanse the bowel in traditional screening colonoscopy. As the "PillCam COLON capsule" makes its way through the GI tract it snaps pictures. The device is recovered by the patient and the images uploaded for analysis by the healthcare provider.

Capsule Endoscopy versus Colonoscopy for the Detection of Polyps and Cancer is published in this week's NEJM. Results were disappointing, with only about three-quarters of the lesions found at colonoscopy also identified with the device.

So it's looking like traditional colonoscopy is still the way to go, at least for now. Other topics we talked about this week include Disclosure of APOE Genotype for Risk of Alzheimer's Disease and Longitudinal Modeling of Age-Related Memory Decline and the APOE 4 Effect, also in NEJM, and Coronary Artery Calcification Screening and Active Commuting and Cardiovascular Disease Risk in this week's Archives of Internal Medicine. Until next week, y'all live well.

1 comment:

  1. Through a recent study, it has been found that a miniscule video camera implanted inside a pill could spot unusual growths in the colon or rectal region, but not as accurate as colonoscopy does. A scientist have stated that pillcam colon was safe, and can visualise the colon. If its really effective, then one can go for it.


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