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Technologist in control room
for CT colonography

Image courtesy of

CT colonography coverage boosts cancer screening rates

by Lauren Dubinsky , Senior Reporter
New research published in Radiology found that about 50 percent more patients are likely to get screened for colorectal cancer if their insurance policies provide coverage for CT colonography.

"Let's face it — the average person does not like getting a colonoscopy," Patrick Hope, executive director of MITA, told HCB News. "But we have this new technology that is less invasive and according to this study, it's clearly a motivating factor for people to get screened."

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Colorectal cancer is the second leading cause of cancer death in the U.S. despite its 90 percent cure rate if it's detected early. In 2014, 139,992 Americans were diagnosed with colorectal cancer, and 51,651 died from the disease, according to the Center for Disease Control and Prevention.

The American Cancer Society recommends CT colonography as one of the screening tests that can find both precancerous polyps and cancer in people ages 50 and older. However, Medicare and many private payors don't provide coverage for it.

Since screening adherence rates for colorectal cancer have stalled at about two-thirds of the people who need to be screened, Dr. Maureen A. Smith of the University of Wisconsin-Madison and colleagues decided to investigate whether insurance coverage would make a difference.

They evaluated overall colorectal cancer screening rates for 33,177 patients under age 65 who were eligible and due for screening. The data revealed that about half were screened during the study period.

The team then compared screening rates between those with and without insurance coverage for CT colonography, and found that those with coverage had a 48 percent greater likelihood of being screened by any method than those without coverage.

"The message is for more insurers to start covering CT colonography," said Hope. "We are starting to see private payors start to go into this space — Aetna did it a couple of months ago."

In June 2016, the United States Preventive Service Task Force assigned an "A" grade to CT colonography, and federal law mandates that private insurers cover these exams with no copay. Most already do, but Medicare does not.

Medical societies and patient advocates including the American College of Radiology, American Gastroenterological Association, Colon Cancer Alliance and Prevent Cancer Foundation support coverage for CT colonography.

“Medicare coverage of virtual colonoscopy would boost screening and save lives. It would help many seniors avoid extensive treatment and reduce costs," Dr. Judy Yee, chair of the ACR Colon Cancer Committee, said in a statement. "Virtual colonoscopy can both prevent cancer and detect cancer. Medicare should cover these exams."

But Smith thinks it's unlikely that Medicare will provide coverage any time soon. She added that any national change would probably rely on Medicare's decision-making process.

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