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The role of optical and virt ual colonoscopy in colorectal neoplasms

V. Ignatov, N. Kolev, A. Tonev, T. Kirilova, V. Bozhkov, K. Ivanov


Purpose: High prevalence of colon carcinoma explains the continued high mortality rate of this disease.Utilizing a strategy of virtual colonoscopy (VC) in patients aged over 50 years with optical colonoscopy (OC) following-up for removal of detected adenomatous polyps may result in lowering the colon cancer death rate. However, VC diagnostic potential has not been widely recognized yet.

Material and methods: This article reviews the currently available in diagnostic options in colorectal neoplasms and discusses their advantages and drawbacks.

Results: VC has many advantages over the existing options and its several drawbacks can be mitigated so that it would become a valuable diagnostic modality. A strategy that utilizes VC for screening of patients over the age of 50 years and OC for screening high-risk individuals and those with positive VC findings would result in a significantly reduced colon cancer mortality rate.

Conclusion: Both OC and VC (i.e., CTC and MRC) progress toward the clinical needs as new technologies are developed and applied to overcome the drawbacks of these diagnostic methods. Each of them plays a unique role for colon cancer prevention.


optical colonoscopy; virtual colonoscopy; computed-tomography colonography; colon cancer; diagnosis

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Byers, T., B. Levin, D. Rothenberger, G. D. Dodd,

R. A. Smith. American Cancer Society guidelines

for screening and surveillance for early detection

of colorectal polyps and cancer: update 1997.

American Cancer Society Detection and Treatment

Advisory Group on Colorectal Cancer.- CA Cancer

J. Clin., 47, 1997, No 3, 154-160.

Cancer Facts & Figures 2008. Atlanta, GA,

American Cancer Society, 2008.

Church, J. M. Clinical significance of small

colorectal polyps.- Dis. Colon Rectum, 47, 2004, No

, 481-485.

Eddy, D. M. Screening for colorectal cancer.- Ann.

Intern. Med., 113, 1990, No 5, 373-384.

Fearon, E. R., B. Vogelstein. A genetic model for

colorectal tumorigenesis.- Cell, 61, 1990, No 5,


Grandqvist, S. Distribution of polyps of the large

bowel in relation to age. A colonoscopic study.-

Scand. J. Gastroenterol., 16, 1981, No 8, 1025-1031.

Hill, M., B. Morrison, H. Bussey H. Aetiology of

adenoma-carcinoma sequence in the large bowel.-

Lancet, 1, 1978, No 8058, 245-247.

Jass, J. R. Classification of colorectal cancer based

on correlation of clinical, morphological and

molecular features.- Histopathology, 50, 2007, No 1,


Jemal, A., R. Siegel, E. Ward, Y. Hao, J. Xu, T.

Murray, et al. Cancer statistics, 2008.- CA Cancer J.

Clin., 58, 2008, No 2, 71-96.

Johnson, D. A., M. S. Gurney, R. J. Volpe, D. M.

Jones, M. M. Van Ness, S. J. Chobanian, et al. A

prospective study of the prevalence of colonic

neoplasms in asymptomatic patients with an agerelated

risk.- Am. J. Gastroenterol., 85, 1990, No 8,


Lieberman, D. A., J. Holub, G. Eisen, D. Kraemer,

C. D. Morris. Prevalence of polyps greater than 9

mm in a consortium of diverse clinical practice

settings in the United States.- Clin. Gastroenterol.

Hepatol., 3, 2005, No 8, 798-805.

Odom, S. R., S. D. Duffy, J. E. Barone, V. Ghevariya,

S. J. McClane. The rate of adenocarcinoma in

endoscopically removed colorectal polyps.- Am.

Surg., 71, 2005, No 12, 1024-1026.

Potter, J. D., M. L. Slattery, R. M. Bostick, S. M.

Gapstur. Colon cancer: a review of the epidemiology.-

Epidemiol. Rev., 15, 1993, No 2, 499-545.

Rickert, R. R., O. Auerbach, L. Garfinkel, E. C.

Hammond, J. M. Frasca. Adenomatous lesions of

the large bowel - an autopsy survey.- Cancer, 43,

, No 5, 1847-57.

Robbins, D. H., S. H. Itzowitz. The molecular and

genetic basis of colon cancer.- Med. Clin. North

Am., 86, 2002, No 6, 1467-1495.

Simons, B. D., A. S. Morrison, R. Lev, W. Verhoek-

Oftendahl. Relationship of polyps to cancer of the

large intestine.- J. Natl Cancer Inst., 84, 1992, No

, 962-966.

Stryker,S. J., B. G. Wolff, C. E. Culp, S. D. Libbe,

D. M. Ilstrup, R. L. MacCarty. Natural history of

untreated colonic polyps.- Gastroenterology, 93,

, No 5, 1009-1013.

Winawer S. J., A. Zauber for the National Polyp

Study Workgroup. The National Polyp Study:

temporal sequence of evolving colorectal cancer

from normal colon.- Gastrointest. Endosc., 33, 1987,

No 2, p. 167 (abstract).

Winawer, S. J., R. H. Fletcher, L. Miller, F. Godlee,

M. H. Stolar, C. D. Mulrow, et al. Colorectal cancer

screening: clinical guidelines and rationale.-

Gastroenterology, 112, 1997, No 3, 594-642.



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About The Authors

V. Ignatov
St. Marina University Hospital of Varna

First Clinic of Surgery

N. Kolev
St. Marina University Hospital of Varna

First Clinic of Surgery

A. Tonev
St. Marina University Hospital of Varna

First Clinic of Surgery

T. Kirilova
St. Marina University Hospital of Varna

First Clinic of Surgery

V. Bozhkov
St. Marina University Hospital of Varna

First Clinic of Surgery

K. Ivanov
St. Marina University Hospital of Varna

First Clinic of Surgery

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