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Medicare's 'No' on Virtual Colonoscopy Stirs Expert Debate
Date:5/13/2009

Some see it as reliable, less invasive option; others say agency was right to reject coverage,,,,

WEDNESDAY, May 13 (HealthDay News) -- Medicare and Medicaid's decision Tuesday not to pay for a less invasive colon exam known as virtual colonoscopy has some experts applauding the move, while others claim it could cost patients' lives.

Virtual colonoscopy, also known as CT colonography, is a procedure in which a detailed picture of the colon is created by an X-ray machine linked to a computer. Although the bowel must be prepped beforehand, it is much less invasive than standard colonoscopy, which usually involves sedation while a doctor examines the colon through an inserted scope and camera.

However, in a memo posted on its Web site Tuesday, the Centers for Medicare and Medicaid Services (CMS) said, "We have determined that there is insufficient evidence on the test characteristics and performance of screening CT colonography in Medicare-aged individuals, and that the evidence is not sufficient to conclude that screening CT colonography improves health benefits for asymptomatic, average-risk Medicare beneficiaries."

Supporters of the procedure weren't pleased by the move. Dr. J. Leonard Lichtenfeld, deputy chief medical officer for the American Cancer Society, believes that a less-invasive method such as virtual colonoscopy might encourage more Americans to get screened for colon cancer, the country's second-leading cancer killer.

"To say the least, I am personally very disappointed," Lichtenfeld wrote on his blog. "For me, the issue was reasonably straightforward -- we lose close to 50,000 people every year in this country from colorectal cancer. We could save thousands of lives if we were able to get people screened for this disease. The American Cancer Society believes that we should favor tests that prevent cancer, and has endorsed CT colonography as a reasonable test for this purpose."

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