Patient FAQs

Colon Cancer is the second leading cause of cancer deaths (2007 estimate: 53,000), and the third leading cause of newly diagnosed cancers (2007 estimate: 154,000) in the US. The American Cancer Society estimates that as many as 90% of all Colon Cancer cases and deaths are preventable with early detection through timely screening. Tragically, less than 50% of the eligible population in the US gets appropriate testing for Colon Cancer. Therefore, tens of thousands of Americans are dying needlessly from Colon Cancer every year.

Don't take a risk with your life!  Get screened for Colon Cancer now!

The American Cancer Society recommends that average-risk adults should begin Colon Cancer screening at the age of 50 years and to continue periodically throughout life. Your doctor may recommend Colon Cancer screening for you prior to age 50. One reason for this earlier recommendation is if your doctor determines that you are at higher than average risk for Colon Cancer.

Many experts recommend earlier screening (starting age 45) for African-Americans, who have a higher risk for colon cancer.

Some of the characteristics of higher risk individuals include:

1. a personal history of polyps or colon cancer in the past;
2. a history of colon cancer in a first-degree family member (parent, sibling, or child); and
3. a personal history of inflammatory bowel disease; or
4. a history or suspicion of certain higher risk hereditary conditions [eg. hereditary nonpolyposis colon cancer (HNPCC) or familial adenomatous polyposis (FAP)].

For example, if told that a first degree relative has a history of polyps, your doctor should recommend colon cancer screening earlier (eg. age 40). The intervals for subsequent screening depend on your history and the results of your initial screening.

In March 2008, the American Cancer Society updated their guidelines for Colon Cancer Prevention and Screening. This guideline can view viewed here (PDF) »

1. Flexible Sigmoidoscopy (Flex Sig): a scope test looking at the first 24 in. of the colon only (Rarely done because if views only a fraction of the colon)
2. Double-contrast barium enema (DCBE): An x-ray test looking at a barium-filled colon (An older test that has largely been supplanted by the following two)
3. Traditional (optical) Colonoscopy (OC): a scope test looking at the entire length (60-70 in.) of the colon lining
4. Virtual Colonoscopy/CT Colonography (VC): A non-invasive test looking at the entire length of colon lining using 3-D reconstructed images from a specialized CT scanner.

While all four of these tests are "recommended" by the major medical guidelines, only OC and VC are highly sensitive for detecting polyps and cancers (approximately 90% sensitive). The other recommended tests are significantly less sensitive (50-60% sensitive--meaning it might miss as many as half of the polyps and cancers that might be present in the colon). Therefore most physicians currently recommend OC or VC for screening.

Traditional Colonoscopy is a very good screening test because it visualizes the entire colon, is highly sensitive, and enables the physician to remove polyps and early cancers during the same procedure.

Traditional colonoscopy has some major drawbacks, however. It is an invasive test, and can be painful without sedation or anesthesia. Because anesthesia is usually given during colonoscopy, the patient must spend time in the recovery room while the anesthesia wears off. Furthermore, the patient is not allowed to drive until the following morning following the exam and will often miss work that day. Therefore, the rest of the day is usually lost after a traditional colonoscopy.

Also, since traditional colonoscopy is an invasive test, it carries risks to the patient. Besides the well-know risks of anesthesia, traditional colonoscopy also carries the risk of bleeding and bowel perforation. This serious potential side effect occurs in approximately 2 patients for every 1000 colonoscopies, and often results in the need for emergency surgery.

VC, also known as CT Colonography, is a non-invasive and technologically-advanced new screening test for Colon Cancer. VC is an imaging test that is performed by an advanced CT scanner. Images of the patient's abdomen are taken by the CT scanner. With special software, these images are put together to create a three-dimensional image of the colon. This 3-D image of the colon provides a similar view of the inside of the colon that is seen by traditional colonoscopy. In fact, the views provided by VC are, in many ways, even better than those seen by traditional colonoscopy.

Furthermore, since VC results are derived from images similar to regular abdominal CT scans, the test can sometime find abnormalities and early cancers existing outside the bowel in the abdomen.

VC is a non-invasive test. It does not require the insertion of an endoscope throughout the colon and therefore has none of the same risks that traditional colonoscopy does.

 

VC does not require sedation or anesthesia. Therefore the patient is able to immediately resume all activities, including driving and work. It is quick--completed in about 10-15 minutes.

 

Recent studies of VC show that it is as sensitive for detecting polyps and cancers as traditional colonoscopy. Furthermore, the American Cancer Society has endorsed VC, along with traditional colonoscopy, as a first-line screening and prevention test for Colon Cancer. In fact, in many ways, the images provided by VC are even better than those seen by traditional colonoscopy. This is because VC can often see corners, folds, and nooks and crannies of the bowel easier and than traditional colonoscopy.

 

Furthermore, unlike traditional colonoscopy, which only sees the inside of the colon, a VC also provides images of the rest of the abdomen. While VC images are not a substitute for a complete abdominal CT scan (if one is indicated for other reasons), these VC images can often detect early cancers and other abnormalities in abdominal organs. Many people have been cured of abdominal cancers before they developed symptoms because they were detected early by VC.

While VC is a great, new, non-invasive technology, there are a few limitations.

First, there is no polyp removal capability with VC. If polyps are detected (approximately 10%-20% of average risk patients), a traditional colonoscopy needs to be performed to remove them.

Second, patients who undergo VC will need to perform a 12 hour, pre-test colon cleansing prep similar to that required by traditional colonoscopy.

The innovative process--Integrated VC--employed by Colon Health Center of Delaware greatly reduces the impact of these two limitations. The CHC Delaware process allows patients to fully benefit from all the many advantages of VC, while greatly reducing the impact of the two limitations. (See What is so innovative about "Integrated Virtual Colonoscopy" at the Colon Health Centers of Delaware?)

The CHC Delaware Colon Cancer screening process, Integrated VC, represents the ultimate in patient convenience, comprehensiveness, and safety. The patent-pending CHC Delaware process brings together the best aspects of VC and traditional colonoscopy, and minimizes the limitations of both, in a way that cannot be replicated elsewhere.

The majority of average risk patients (80%) who present for screening will not be found to have colon polyps or other abnormalities that would need to be removed. It is unfortunate that these patients have to undergo the additional risk and inconvenience of a traditional colonoscopy, only to find a "clean" colon.

On the other hand, 20% of patients who receive a stand-alone Virtual Colonoscopy will have polyps and early cancers detected on VC that will need to be removed. It is unfortunate that these patients first need to undergo a colon prep for the VC, and later will be notified that they will have to schedule an appointment for a traditional colonoscopy to remove the abnormalities, and undergo a second colon prep all over again!

Integrated VC streamlines and eliminates these problems by creating a "Colon Health Center"--a Virtual Colonoscopy imaging center together with traditional colonoscopy endoscopy center.  This allows the vast majority of patients to complete screening with only the non-invasive, sedation-free test, enabling them to drive themselves immediately home, to work, etc.  Those patients with discovered polyps can undergo an immediate polyp removal colonoscopy without needing to take a second colon prep!

Patients arrive at the Colon Health Center after performing an overnight colon prep. They receive their VC, which takes approximately 10-15 minutes. When patients receive a VC at a CHC America site, images will be immediately sent to the CHC America reading site, staffed by the most experienced and expert VC readers in the country. Within 45-60 minutes, the patient's VC reading will return and the patient will be notified whether or not they have any colon abnormalities. If they happen to be one of the lucky 80% of average risk individuals, they are done and can immediately resume all activities.

If they are among the 20% of individuals with polyps or other abnormalities, they will be immediately directed to the co-located endoscopy center where they will undergo a traditional colonoscopy and remove the abnormalities.

No need for a second prep! No second day off work! Pure convenience designed around the needs of patients.

At Colon Health Center of Delaware, your exam will always be read by one of the highly experienced American-trained, Board-certified, radiologists at CHC Radiology. The radiologists who read CHC Delaware studies are national experts in VC. In many cases, VC is all they read--all day, every day. Studies have clearly shown that experience dramatically improves one's ability to read VCs.

At stand-alone radiology centers and hospitals, the readers are usually community radiologists who read x-rays, ultrasound, MRI, CT and many other types of studies, and have limited experience in reading VC. At other centers, VC studies are being read by GI physicians who are trying to learn to be radiologists and are reading CT studies for the first time.

Don't settle for a non-expert reading your study. With CHC Delaware, you will only have the best, most experienced VC readers in the country reading your study.

Other centers cannot offer "Integrated VC".  VC is a test that may also offered at stand-alone radiology and imaging centers. But the vast majority of these centers will have no capability to follow-up with a traditional colonoscopy. Therefore, patients receiving VCs at these centers will be forced to take a second day off work and undergo a second colon prep! Who would want to take that risk?

Furthermore, the radiologists who read CHC Delaware studies are national experts in VC. In many cases, VC is all they read--all day, every day. Studies have clearly shown that experience dramatically improves one's ability to read VCs. With CHC Delaware, you will only have the best VC readers in the country reading your study.

Please see "What to Expect with Virtual Colonoscopy"

Yes, there is radiation exposure with any x-ray or CT scan. Fortunately, with advances in CT technology the radiation exposure from VC is minimal and is similar to the radiation exposure that one encounters naturally by simply being outdoors for a period of time, and is significantly less than the exposure from previously approved screening studies.  Equipment used at CHC America centers is the latest technology and therefore performs VC with the smallest possible radiation exposure.

The short answer is "nowhere". CHC Delaware has a patent pending with the US Patent and Trademark Office on "Integrated VC", their innovative and comprehensive, same-day screening methodology in the community. Furthermore, CHC Delaware has a passion for improving patient satisfaction with its Colon Cancer screening process. After all, satisfied patients are more likely to get screened and therefore prevent colon continues to improve and perfect this patient-centered approach to Colon Cancer screening.