If You're Due for a Colonoscopy, Consider the Virtual Route

Are there any people for whom CT colonography might not be appropriate or might not benefit? Should people who have a family history of colorectal cancer just stick with the tried-and-true method?

I don't think so. I think even in people that have family history with a slightly increased risk over the average population, a large portion of these are going to be negative. So I think using CT colonography is valid in this instance. In our standard patients, 87 percent of the exams are negative and only 13 percent are positive. One of the questions that referring physicians ask is, "Why would you go to CT colonography if you'd have to get two exams for a positive study, whereas with optical colonoscopy you're already there and you just take it out, so it's just one exam?" And my answer to them is the fact that in a screening population, the probability that you'll have a polyp greater than 5 millimeters is low.

What are some of the complications that can occur with traditional colonoscopy?

The most feared is perforation. With a fiberoptic scope, there can be direct, mechanical causes that put a little hole in the bowel. And if you take a polypectomy, you can create a little hole, too. If you get a bowel perforation, it's a pretty big thing. The vast majority will probably result in a surgery, and you may have to get a part of your colon taken out. Fortunately, that doesn't happen superfrequently.