Newswise — The evidence standard that the Centers for Medicare & Medicaid Services (CMS) used to approve Medicare coverage of a stool DNA colorectal cancer (CRC) screening test, under a new joint approval process with the Food and Drug Administration, should be applied to CT colonography (virtual colonoscopy) and other CRC screening exams. In a new letter to CMS, the American College of Radiology urged that coverage criteria be transparent and consistently applied.
Studies show that virtual colonoscopy detects colorectal cancer and precancerous polyps far better than the stool DNA test, is more cost effective and results in fewer ”false-positive” exams, which can reduce downstream costs and patient anxiety. CT colonography is recommended every five years while the DNA test would be done every three years. This less frequent testing may further lower costs and attract more people to be screened.
“CT colonography is an American Cancer Society recommended screening test. The exam’s performance far exceeds the standard applied to the DNA test. Transparent evidence-based approval, and the need for more screening options for the nation’s second leading cancer killer, require that Medicare cover beneficiaries for CT colonography,” said Judy Yee, M.D., chair of the American College of Radiology Colon Cancer Committee.
Studies in the New England Journal of Medicine and Radiology confirm CT colonography is comparably accurate to standard colonoscopy – including in those ages 65 and older. Studies at National Military Medical Centers in Bethesda, Md., and in San Diego, show that CT colonography availability significantly boosts colorectal cancer screening rates. President Obama had a CT colonography exam in his first checkup as commander in chief.
CIGNA, UnitedHealthcare, Unicare, Anthem Blue Cross Blue Shield and other major insurers already cover screening CT colonography. More than 20 states require coverage of CT colonography. Yet, Medicare does not cover beneficiaries for the exam.
“We are pleased that Medicare is giving seniors more screening options. CT colonography finds cancers and precancerous polyps as well as conventional colonoscopy in most people and significantly outperforms the DNA test. Given Medicare’s recent precedent-setting coverage decision, it is time for Medicare to cover beneficiaries for CT colonography,” said Yee.
CT colonography is far less invasive and costly than colonoscopy. Sedation is not required. Afterward, people can go back to their daily activities. National Institutes of Health researchers found that benefits of virtual colonoscopy clearly outweigh any low radiation risk. Americans get roughly the same minimal amount of radiation each year from environmental sources. Because CT colonography scans the entire abdomen, it can spot cancers and other serious illnesses in organs other than the colon, including abdominal aortic aneurysms. This can lead to early diagnosis and treatment of previously undetected problems and save even more lives.
To speak with an ACR representative, contact Shawn Farley at 703-648-8936 or [email protected].