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CMS Denial of Coverage for Virtual Colonoscopy May Cost Lives
Date:5/12/2009

Congress should step in and vote to mandate coverage of CTC."

Colorectal cancer is the third most common cancer diagnosed among men and women in the United States and the second leading cause of cancer death, despite having a 90 percent cure rate when detected early. This is because less than half of those 50 and older who should be screened for the disease opt to receive the screening exams currently covered by Medicare.

Noninvasive CT colonography uses cutting-edge x-ray technology to create three dimensional, fly-through images of the entire colorectal structure. The exam does not require sedation and patients may resume their normal daily activity immediately following. This has the ability to attract far more people to be screened and ultimately save lives.

"The percentage of patients at risk for the disease who have opted to be screened has not dramatically increased in more than 30 years. CTC is the technology that can overcome many stigmas associated with colorectal cancer screening, get more patients to be screened, and dramatically reduce the number of people who die unnecessarily each year from this disease," said Elizabeth McFarland, M.D., chair of the ACR Colon Cancer Committee.

Major insurers CIGNA and UnitedHealthcare already cover screening CT colonography nationwide while Anthem Blue Cross Blue Shield provides coverage in certain states. Particularly in light of recent clinical trials affirming CT colonography's accuracy, the CMS refusal to cover this exam in effect represents a reinforcement of a two-tier approach to coverage of screening for this deadly disease: one for those who have private insurance and lesser coverage for Medicare beneficiaries.

The CMS determination to not cover CT colonography will be particularly felt in minority and underserved populations. The Journal of the American Geriatrics Society released a study demon
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SOURCE American College of Radiology
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