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Asset or Liability?

Robert H. Fletcher, MD, MSc; Michael Pignone, MD, MPH

Arch Intern Med. 2008;168(7):685-686.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Computed tomographic colonography (CTC) was developed as a screening test for colorectal cancer. This test detects large polyps and cancers about as well as optical colonoscopy,¹ suggesting that it, like currently accepted tests, can reduce colorectal cancer incidence and mortality. But unlike other colorectal cancer screening tests, CTC also visualizes the abdomen and lower thorax and finds abnormalities there too. Is this extra information an asset or a liability?

When it comes to incidental findings, clinicians tend to be in opposing camps. Some see possibilities for good—a glass half full. They believe that finding incidental abnormalities might well be a good thing and finding them earlier would be even better. After all, they argue, imaging detects cancers at an earlier stage, and localized cancers have a better prognosis than advanced disease. Finding and repairing aneurysms when they are asymptomatic prevents the . . . [Full Text of this Article]

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