Comparative Effectiveness of CTC & OC

The goal of this study is to compare, both clinically and from a cost-effectiveness
perspective, virtual or CT-C (CT-Colonography) to standard CT scan and optical colonoscopy
(OC). Virtual colonoscopy is a combination of a radiologic evaluation of the abdomen and
pelvis with intra-colonic imaging. Previous research supports the concept that CT-C may be
an effective substitute for the current OC and address limited compliance for surveillance
for CRC survivors. Post-operative CRC surveillance strategies are effective, but depend upon
patient compliance which is less than desired. Improved adherence is linked with greater
cost-effectiveness as well as better clinical outcomes. CT-C possesses potential advantages:
convenience as a single test, less risk, possibly patient preference and lower total costs.
Costs would be reduced through direct (provision of fewer optical colonoscopies) and
indirect means (reduction in time lost from work by patient and chaperone, etc.). When
extrapolated across the roughly 200,000 OCs performed annually in the US for this indication
reduced utilization of even 50% in a high unit cost procedure like OC would yield
substantial savings without a reduction in clinical quality.

Inclusion Criteria:

- Patients with a history of CRC without clear evidence of metastatic disease who have
completed their acute cancer-specific treatment

- Patients aged 18 years or older

- Patients who have signed an approved informed consent form

Exclusion Criteria:

- Patients with a diverting ileostomy, with a history of inflammatory bowel disease,
FAP, or active GI symptoms (gastrointestinal bleed, diarrhea, severe abdominal pain,
etc.)

- Patients who are pregnant