by Brendon Nafziger
, DOTmed News Associate Editor | June 03, 2010
A bill backed by the American College of Radiology could make Medicare pay for virtual colonoscopies.
On Friday, Representatives Danny Davis (D-IL) and co-sponsors Mark Kirk (R-IL) and Dan Boren (D-OK) introduced the Virtual Screening for Colorectal Cancer Act of 2010, or H.R. 5461, into the House of Representatives. The bill calls for the Centers for Medicare and Medicaid Services to provide coverage for CT scans of the colon, known as computed tomography colonographies.
"Fifty to 70 percent of the people who should be being screened for colon cancer aren't getting screened, and those numbers [of people getting exams] aren't going up drastically," Shawn Farley, a spokesman for ACR, told DOTmed News.
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CT colonography exams involve a 3D X-ray scan of the colon. Some consider the procedure attractive to patients wary of getting colonoscopies. Unlike the colonoscopy, the CTC procedure only takes a few minutes. And while a 2-inch tube is inserted in the rectum to inflate the bowels with gas or liquid, the colonoscope is much longer. ACR and the American Cancer Society both note that it could be less expensive than conventional colonoscopies.
While no official studies have been done on whether virtual colonoscopies increase compliance for screening, the Walter Reed Hospital in Washington, D.C. found a 70 percent increase in compliance once they started offering the CT exams, Farley said.
Some health plans already cover the procedure, one of the first screening exams President Barack Obama received after he took office. CIGNA, UnitedHealthcare and Anthem Blue Cross Blue Shield all cover screening and diagnostic CT colon scans, ACR noted. The American Cancer Society also includes it among its recommended screening tools.
Because it's not covered by Medicare, ACR warns of a "two-tiered" approach to screening coverage, hurting those reliant on Medicare who lack private health insurance or who can't afford to pay for exams out of pocket.
"It's time for all patients who want a CT colonography to be covered for this lifesaving exam," Dr. Judy Yee, chair of the ACR Colon Cancer Committee, said in a statement.
But not all doctors are as supportive of virtual colonoscopies. In a letter to the U.S. Food and Drug Administration in April, the American College of Gastroenterology said that CT colonographies might be useful for some patients but cautioned that "there is no demonstrable evidence that CT colonography prevents the development of CRC [colorectal cancer] or reduces CRC mortality rates" and argued that using the exams might increase health care costs.