Navigation Links
Penn Study finds virtual colonoscopy is used appropriately, may expand screening to more patients
Date:4/5/2013

PHILADELPHIA In 2009, the Centers for Medicare and Medicaid Services (CMS) halted reimbursement for so-called "virtual colonoscopy" for routine colon-cancer screening in asymptomatic patients, in part due to concerns over how this procedure, computed tomography colonography (CTC), was being used in the elderly population. In the first study to examine appropriate utilization of the test among asymptomatic Medicare beneficiaries from 2007 to 2008, a research team from the Perelman School of Medicine at the University of Pennsylvania found that CTC was used appropriately and may have expanded colorectal cancer screening beyond the population screened with standard ("optical") colonoscopy. The findings, led by Hanna M. Zafar, MD, MHS, an assistant professor of Radiology, are published online in the Journal of General Internal Medicine.

CTC is a minimally invasive method of visualizing the colon and rectum, which does not require sedation, unlike during standard colonoscopies. On average, CTC costs $400 to $800, and optical colonoscopy costs $1,500 to $3,000. However, patients with focal abnormalities on CTC (defined as suspected polyps greater than or equal to 6 mm and masses) must be referred to OC for direct tissue sampling.

The Penn Medicine research team examined records for 10,538 asymptomatic older patients who underwent CTC compared to 160,113 similar patients who underwent optical colonoscopy. They found that the vast majority of patients who received CTC had presumed incomplete optical colonoscopies and thus were considered appropriate candidates for the virtual screening method. Furthermore, almost half of the patients studied who underwent CTC following incomplete optical colonoscopy did so on the same day as optical colonoscopy. "Given that bowel preparation is a strong barrier to screening, offering same day CTC could improve completion of screening by eliminating the need for an additional bowel preparation," said Zafar. "As such, it is reassuring that CTC following incomplete optical colonoscopy is covered by most insurance companies and CMS."

Additionally, 30 percent of the patients who underwent CTC had no history of incomplete OC but demonstrated other medically appropriate indications for screening CTC including risk of bleeding or sedation complications. Although the researchers were not able to assess through the claims data studied how many of these patients would not have been screened without the option of CTC, it does suggest that during the study period, this test may have expanded colorectal cancer screening as opposed to simply replacing optical colonoscopy. (Prior research has shown that nearly 30 percent of patients would not undergo optical colonoscopy if CTC were not available.) "Additional research is needed in this important area since approximately 40 to 50 percent of Medicare patients do not undergo any recommended method of colon cancer screening," Zafar said.

The Penn Medicine study also found lower utilization of CTC among asymptomatic non-white patients. It is not clear whether this decreased utilization is due to overall lower rates of colorectal cancer screening in this group of patients, patient preference, or diminished access to imaging technology. But previous findings indicate that minority populations are less likely to be aware of colorectal cancer screening procedures and more likely to believe that screening is only needed after symptoms develop -- both represent barriers to colorectal cancer screening compliance. "Given the higher incidence and mortality from colorectal cancer among black patients and lower rates of screening in minority patients overall, this cohort could benefit most through CTC," said Zafar.

Colorectal cancer was the third most commonly diagnosed cancer among men and women, as well as the third leading cause of cancer death for 2012 in the United States. Although it is largely preventable through colonoscopy, screening remains underutilized. In light of their findings, the study team suggests that reimbursement for screening CTC may increase overall screening rates in the elderly but could simultaneously exacerbate disparities in colorectal cancer screening.

CMS' decision to end reimbursements in 2009 was subsequently opposed by several groups such as the American Cancer Society and American College of Radiology, which both recognize CTC as a recommended screening procedure for Americans ages 65 years and older.


'/>"/>

Contact: Steve Graff
stephen.graff@uphs.upenn.edu
215-349-5653
University of Pennsylvania School of Medicine
Source:Eurekalert

Related medicine news :

1. DrugRisks Adds Study Showing Pradaxa Viral Infection Risk
2. Brisk Walking Equals Running for Heart Health: Study
3. Not all patients benefit equally from hip or knee replacement: Study finds
4. Study reveals that chemotherapy works in an unexpected way
5. Balding Men Could Face Higher Heart Risks, Study Finds
6. U.S. Spends More on Dementia Care Than Heart Disease or Cancer: Study
7. Prostate cancer treatment study changing the way doctors practice
8. Dementia costs top those for heart disease or cancer, study finds
9. Nutralife Hails New Study’s Findings on SAM-e, Giving Hope to Millions Seeking Joint Relief
10. Low Testosterone Linked to Later Arthritis in Study
11. Black Men Often Face Delays in Prostate Cancer Care: Study
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/24/2017)... McKinney, Texas (PRWEB) , ... February 24, 2017 , ... ... south to The Medical Center at Craig Ranch building at 8080 State Highway 121, ... Ranch Medical District with easy access to Highway 121. , As the practice has ...
(Date:2/24/2017)... , ... February 24, 2017 , ... The California ... conference convening academic faculty engaged in or interested in palliative care education and research. ... will be held in North County San Diego on Sept. 28 and 29, 2017, ...
(Date:2/24/2017)... ... February 24, 2017 , ... Indiana Fiber Network (IFN) President and CEO Kelly ... Dyer started as the Chairman of the Management Committee when IFN was originally ... including the recruitment of investor/owners and development of the business plan. He became ...
(Date:2/24/2017)... ... February 24, 2017 , ... Congratulations to Head Over Heels’ ... February 12th. Ms. Esparza qualified into this prestigious status after winning the ... Las Vegas, Nevada. Frida is one of approximately 25 gymnasts in the nation ...
(Date:2/23/2017)... ... February 23, 2017 , ... On February ... a letter to withdraw previous guidance issued by the Obama Administration ... guidance issued in May 2016 by the Obama Administration came in response to ...
Breaking Medicine News(10 mins):
(Date:2/24/2017)... , Feb. 23, 2017 The ... of the PhenoTest BC Kit, performed on the ... identify organisms that cause bloodstream infections and provide ... to respond to (antibiotic sensitivity). The test also ... provide this important information, which can guide antibiotic ...
(Date:2/24/2017)... 2017  Directors from Pharma To Market Pty Ltd and Ador ... resulting in the founding of Pharma To Market Pte Ltd, based ... are pleased to announce their expansion into Asia ... . The company are delighted to appoint Joelle Chia ... Singapore based entity. Joelle brings with her an ...
(Date:2/24/2017)... Medivir AB (Nasdaq Stockholm: MVIR) ... Board of Directors that will be submitted to the ... representatives of the company,s three largest shareholders at the ... accepted a seat on the Nomination Committee, and the ... Nomination Committee was as follows:  ...
Breaking Medicine Technology: