CT Colonography: A Cancer Screening We Can All Get Behind

kjchang_photo_This post was contributed by Kevin J. Chang, MD, FSAR, Director of CT and IT at Newton-Wellesley Hospital in Newton, Massachusetts and a member of the American College of Radiology (ACR) Colon Cancer Committee

Each year in March, for Colorectal Cancer Awareness Month, we pause to consider that more than 145,000 Americans are diagnosed with colorectal cancer each year, and over 50,000 die because of late detection. This is all the more tragic when you consider that colorectal cancer is largely preventable—and has a 90 percent cure rate when detected early through recommended screenings.

In 2018, the American Cancer Society published their updated guidelines for colorectal cancer screening, which concluded that adults aged 45 years and older with an average risk should undergo regular colorectal cancer screening every five years. The United States Preventative Task Force (USPSTF) has given colorectal cancer screening an “A” rating. CT Colonography (CTC), often known as “virtual colonoscopy,” is one of the available screening options.

There is widespread agreement among the medical community that the best colorectal screening test is the one that gets done. Virtual colonoscopy does not require sedation. It is over in minutes. You can go back to daily activities and you don’t need anyone to drive you home. These and other unique features of CTC make it an appealing test for many Americans.

The Patient Protection and Affordable Care Act requires private health insurers to provide, without patient cost-sharing, all preventive services that earn grades of A or B in USPSTF recommendations – so CTC is covered by insurers. That’s good news for many.

However, the Centers for Medicare and Medicaid Services has yet to grant reimbursement for Medicare beneficiaries who choose CTC for screening in lieu of conventional screening colonography despite the USPSTF’s previous positive recommendation. That leaves millions of Americans unable to choose CTC, a test that could save their lives. Many of these may forego any colorectal cancer screening at all.

The ACR’s Colon Cancer Committee, along with government relations staff, have been working to pass legislation that would mandate Medicare coverage of CTC. Last year’s bill had 86 co-sponsors, and we anticipate this session’s version of the legislation to be introduced in the next few days.

The ACR also recently submitted a comment letter to the USPSTF regarding the task force’s draft research plan for an upcoming five-year review of its recommendations for colorectal cancer screening.

The bottom line: CTC is life-saving, safe, cost-effective and could reduce the racial and ethnic disparities that plague colorectal cancer screening adoption.

For more information, please consult the ACR’s Colon Cancer Screening Resources and encourage your patients to learn more at RadiologyInfo.org.

  • How are you working to educate patients, primary care physicians and lawmakers about CTC?
  • Join the conversation all month long on social media using hashtags #VirtualCT, #CTColonography and #CRCAwareness, and by following @RadiologyACR on Twitter.

Please share your thoughts in the comments section below and join the discussion on Engage (login required).

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