What will future bring to colorectal cancer screening? 1.4 million people get diagnosed with colon cancer or rectal cancer every year. But all colorectal cancer cases are preventable by screening. How to choose the best screening method for colorectal cancer? Leading virtual colonoscopy screening expert discusses CT colonography. Virtual colonoscopy.
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Colon cancer screening is easier and more accessible to patients than ever before. Dr. Anton Titov, MD. Virtual colonoscopy with computer analysis makes colorectal cancer screening efficient and very sensitive. Virtual colonoscopy is also known as CT colonography. You are one of the world’s leading radiologists for colon cancer diagnosis and screening. Dr. Anton Titov, MD. What progress in colorectal cancer screening can we expect in the next 5 to 10 years? Dr. Perry Pickhardt, MD. I’d like to say that we would advance to the point of a simple blood test to detect polyps. But, unfortunately, that is nowhere near on the horizon. Although there is a lot of research being done. I’m also hopeful that the stool fecal DNA test might advance. Dr. Perry Pickhardt, MD. Then we no longer need to do even a CT colonography. In reality, advanced imaging will be always a central part of screening patients for colorectal cancer and other cancers. Dr. Perry Pickhardt, MD. Perhaps it will be combined with a blood test. Computer analysis gives us more redundancy and fewer chances to miss cancer and precancerous lesions. Dr. Anton Titov, MD. Computer analysis will continue to improve. The analysis of other organs will improve. For example, looking for fatty liver disease and visceral fat analysis. A number of other tests. Assessment of bone quality. All of these things can be combined to make the CT exam to go beyond just a simple colon cancer test. CT colonography will be a more holistic health exam. Dr. Perry Pickhardt, MD. This is very important future. Because ability to detect early stages or preclinical stages of disease really makes impact on the health of the people. But it also makes impact on the economics of healthcare. Dr. Perry Pickhardt, MD. Potentially, yes. There is also a role for PET scanning to improve the specificity of some of our findings. PET can be used in addition to MRI and other imaging tests. The future is definitely looking bright for presymptomatic detection of cancer. It is really the goal. Because when a patient presents with cancer symptoms, the prognosis is much worse. We must detect cancer before symptoms ever appear. The cancer can then be cured. Dr. Anton Titov, MD. This is ultimate 4 “P” medicine: the personalized medicine, predictive, preventive and participatory for many patients. It is especially important in areas of the world where patients have significant financial burden to access healthcare. Dr. Perry Pickhardt, MD. Yes, absolutely. I guess I should also add ultrasound. It may play a role, especially in some of the more remote corners of the world. Professor Pickhardt, thank you very much for this very interesting and informative conversation. Hopefully we will be able to return to you in the future. Dr. Anton Titov, MD. We hope to discuss more updates and advances on colorectal cancer screening. But also, as you mentioned, a more general CT abdominal screening opportunities. Dr. Perry Pickhardt, MD. It is my pleasure, I enjoyed it! Dr. Anton Titov, MD. Thank you very much! Colorectal cancer screening future. Trends and best methods for colon cancer screening. advanced imaging will be always a central part of screening patients for colorectal cancer and other cancers. This includes virtual colonoscopy (CT colonography). Virtual colonoscopy / CT colonography will be combined to make the CT exam to go beyond a colon cancer test. CT scanning will be a more holistic sort of health screening exam, the whole body CT exam. When patient presents with cancer symptoms, the prognosis is much worse. It’s best if we can detect cancer before symptoms ever appear, perhaps by the whole body CT exam. CT colonography can evolve into more general screening test for abdominal and even lung cancers. Radiologists will learn how to deal better with incidental findings on screening whole body CT scans.