FAQ's
What is CRC?
It may not be something that's fun to talk about, but it is something that's vital to understand. CRC includes cancers of the colon, rectum, appendix and some anal cancers. Almost all cases of CRC begin with the development of benign colorectal polyps. Polyps form when cells lining the colon grow, divide and reproduce in a disorderly way, producing a growth. If the cells of a polyp acquire the ability to invade the intestinal wall and spread to other parts of the body, then a malignant or cancerous tumor develops.
Why get screened?
CRC often has no "early warning" signs at all. This is why it's often referred to as the "Silent Killer". It can be present in people without symptoms, known family history or a predisposing condition such as inflammatory bowel disease. As polyps are relatively easy to detect and treat before they become cancerous, it just doesn't make sense to wait before getting checked out. Delay is the major reason why colon cancer is fatal. THE IDEA IS TO DISCOVER AND TREAT POLYPS BEFORE THEY BECOME CANCEROUS.
What screening methods are used?
Currently there are 5 colorectal screening methods being used. They include Virtual Colonoscopy (VC), Fiberoptic Colonoscopy (FOC), Double Contrast Barium Enema (DCBE), Fecal Occult Blood Test (FOBT) and Flexible Sigmoidoscopy. In practice, however, only 2 have gained recognition as the most effective methodologies, Virtual Colonoscopy (VC) and Fiberoptic Colonoscopy (FOC).
Which method does VScreen use?
The "V" is for virtual. VScreen specializes in Virtual Colonoscopy. We use high-resolution CT Scanners, new cutting-edge diagnostic software and a world class physician base to accurately interpret the results of your test.
How does a Virtual Colonoscopy differ from a Fiberoptic Colonoscopy?
In both cases patients must "endure" a bowel cleaning process - an evening at home taking prescribed bowel cleansing preparations to "clean your system". Nobody likes doing it, but when put in the perspective of potentially saving your life and protecting your family's future and happiness, it should be approached as a minor inconvenience.
Fiberoptic Colonoscopy (FOC) uses a fiberoptic tube (colonoscope) with which a gastroenterologist looks at the inside walls of the colon. For a thorough examination, this tube has to be inserted into the rectum and travel the full length of the entire colon. It is therefore an invasive procedure that often requires sedation. The benefit of this method is that if polyps or abnormalities are found, they can be removed or biopsied during the same procedure.
In contrast, Virtual Colonoscopy (VC) is a non invasive procedure requiring no sedation. Air is used to gently inflate the colon and a CT scanner is used to capture detailed images of the patients abdomen and pelvis area. The patient simply holds his or her breath for a few seconds while a scan is performed as they lay on their back and then on their stomach. The whole procedure can be completed in a matter of minutes. A specially trained radiologist then uses the 2 and 3-dimensional computer generated images to identify candidate polyps, or suspicious findings.
Which method is best for me?
This is a personal decision, and you may wish to consult your doctor. Depending on your age and family history, there is a 90 to 95 percent chance that you will not have polyps that need to be removed. Based on this likelihood, many would prefer a non-invasive Virtual Colonoscopy screening knowing that if polyps are discovered, they can be scheduled for a regular FOC to have them removed or treated.
Does my insurance cover Virtual Colonoscopy screenings?
Virtual Colonoscopy (VC) is a CT scan consisting of images of both the abdomen and pelvis, with air contrast and 3 dimensional reconstruction. Because this is a new colorectal screening technique, many insurance companies may balk at reimbursing for this particular exam. If your doctor orders a CT Abdomen/Pelvis with or without contrast because of symptoms, then most all insurance companies will pay for them.
If the test is ordered and done only for screening purposes, a few will pay, but many will not. We recommend that you contact your health insurance carrier and inquire about any non-reimbursement issues. You have every right as a subscriber of your insurance company to call and request that your premiums cover important exams such as Virtual Colonoscopy (VC). We are currently in discussion with insurance companies emphasizing the fiscal benefits of statewide and nationwide screening programs.
We have developed relationships with supplemental insurers to provide some level of reimbursement relief for patients who have obtained or would like to obtain supplemental cancer coverage. Despite the coverage reimbursing something less than 100%, we feel this form of supplemental coverage is a wise insurance investment for family safety and security. Supplemental cancer coverage is remarkably cheap. If interested, we would be delighted to introduce you to a local broker for additional questions.
Medical Flexible Spending Accounts (FSA’s) and individual Health Spending Accounts (HSA’s) are an excellent method of paying for the cost of Virtual Colonoscopy. With the “use it or lose it” approach to these plans, you are motivated to spend what you’ve been saving pre-tax all year. To the extent that you’ve funded your plan for any portion of a year, you simply have to submit your Virtual Colonoscopy claim to either your employer sponsored plan or your individual plan to receive dollar for dollar reimbursement.
Once again, we would be happy to connect you with local brokers to discuss further the costs and benefits of FSA’s and HSA’s.
Is a bowel prep required for Virtual Colonoscopy?
Yes. A thorough cleansing of the bowel is required for adequate bowel viewing during the exam. Any solid material remaining in the colon would make it impossible to identify small polyps. There are several options when prescribing bowel preps. We recommend Fleet #1 or #3 Phospha-Soda and a liquid diet the day before. However, clinical indications may necessitate other prep solutions.
What if a polyp or tumor is found on the Virtual Colonoscopy?
If a polyp or tumor is found, another test such as flexible colonoscopy or surgery will be required for removal depending upon the findings. This is the same for any non-invasive screening test. We are currently developing partnerships with the gastroenterology community to provide same day, same prep diagnostic/therapeutic treatments if clinically relevant polyps are discovered. This will avoid having to endure 2 bowel preparations.
Is there any radiation exposure in Virtual Colonoscopy?
A Virtual Colonoscopy involves two data acquisition sets. One in both the prone and supine positions. Therefore, more radiation is involved than if you were dealing with a conventional CT scan. However, the amount of radiation involved is still well within safe and acceptable limits. We have made attempts to minimize the radiation dose by lowering CT tube currents to a minimum without interfering with the overall study performance.
Is Virtual Colonoscopy a non-invasive test?
A Virtual Colonoscopy (VC) requires the insertion of a small tube into the rectum (3/4 of an inch) and inflating the colon with air or carbon dioxide. Both techniques have proven to work well. Most patients prefer room air because they can self insufflate their colons and thus have control over any discomfort issues. AT VScreen, we typically prescribe room air.
I am on blood thiners. Will I have to stop them before the Virtual Colonscopy?
No. Since Virtual Colonoscopy is non-invasive, blood thinners do not present a problem as they would in the case if you were considering Flexible Colonoscopy (FOC).
Is the Virtual Colonoscopy safe? Is there a risk of colon perforation?
Virtual Colonoscopy (VC) is extremely safe. Unlike Flexible Colonoscopy (FOC) , there is no risk of colon perforation.
Will I need someone to drive me to and from the Virtual Colonoscopy?
No. Virtual Colonoscopy (VC) does not require any sedation, pain medications, oral or IV medications. As an additional free-of-charge service, VScreen in most cases will provide to and from transportation services for you. Check with your patient care coordinator for details.
Is Virtual Colonoscopy painful?
Patients describe Virtual Colonoscopy (VC) as uncomfortable with mild cramping (but not painful) when the colon is being filled with air contrast. The CT scan can be completed in 1 or 2 breath holds and then the rectal tip is removed and the air is expelled or absorbed.
Is Virtual Colonoscopy as reliable as conventional flexible colonoscopy?
Virtual Colonoscopy (VC) has been shown to be as good as conventional colonoscopy in detecting clinically significant polyps and cancers. Virtual Colonoscopy will visualize the entire colon in most cases. Conventional colonoscopy will fail to visualize the entire colon in 10 to 15% of cases. Imagine a “Gold Standard” service being fully reimbursed by insurance yet missing 25% of the colon in most cases?
