While the majority of hospitals that offer CTC services also offer colonoscopies, a little under one-third didn't. Just 12 percent offered both services.

The authors recommend that hospitals considering offering CTC services form partnerships with organizations that can provide same-day colonscopy follow-ups to increase patient compliance.


"Patients with abnormal findings on CTC might be reluctant to complete the recommended follow-up care if resource or scheduling constraints necessitate that they undergo a second colon preparation," the authors said.

In a series of follow-up interviews in 2009 with six hospitals that provide virtual colonographies and three that did not, the researchers found that reimbursement was a big concern.

Generally, CTCs were rare among the hospitals interviewed. Five out of the six CTC-providing hospitals said they performed fewer than 50 scans a year, and mostly for patients with a failed earlier colonoscopy, who are then eligible for reimbursements. However, one hospital performed more than 1,000 such scans a year, largely because it had an activist radiologist who won over payers.

"One of the radiologists on staff met with local insurers, provided data on CTC, and convinced them to cover the service for all covered patients. As a result, CTC is used for general screening in that community," the authors wrote.

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