Initial virtual colonoscopy can occur later for women than for men

Women can be screened for colon cancer at least 5 to 10 years later than men when undergoing an initial virtual colonoscopy. These newly published findings may help establish guidelines for the use of this screening technique, which is less invasive than a traditional colonoscopy.

Detecting precancerous polyps through the use of imaging techniques such as a traditional colonoscopy may prevent colorectal cancer. However, some people may feel that this technique is too invasive, while others may not be healthy enough to undergo the procedure. A possible alternative is the virtual colonoscopy—a minimally invasive procedure with a very similar accuracy as traditional colonoscopy.

Unlike for traditional colonoscopies, no study has assessed at what age virtual colonoscopies should first be performed. To investigate, Cesare Hassan, MD, of the Nuovo Regina Margherita Hospital in Rome, Italy, and his colleagues studied 7,620 patients who were referred for a first-time screening with virtual colonoscopy from 2004 to 2011. Advanced cancer was ultimately diagnosed in a total of 276 patients (3.6%). Older age and male sex were linked with advanced disease, while body mass index and a family history of cancer were not. The study's results were published in Cancer (2013; doi:10.1002/cncr.28007).

"We showed that the possibility for average-risk individuals to have clinically meaningful polyps detected by virtual colonoscopy is strictly associated with two main variables, namely age and sex," said Hassan. The researchers determined that 51 women younger than 55 years would need to be screened to detect one case of advanced neoplasia, compared with only 10 men older than 65 years. "If you are a man, the best age to have a virtual colonoscopy is between 55 and 60 years, but if you are a woman, you can at least wait until 60 years," said Hassan.
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