Calls for Medicare to Cover a Virtual Lifesaver

Colon cancer CT colonography is as effective as standard colonoscopies

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(RxWiki News) Colonoscopy is an expensive, invasive and costly colon cancer screening method. An easier, less expensive and invasive technique known as a virtual colonoscopy or CT colonography uses a scanner.  

Medicare doesn't cover this for older Americans, and two groups believe it should.

A number of studies, including the largest of its kind, which was recently published online, have concluded that virtual colonography is comparably effective to standard colonoscopy for detecting both pre-cancerous polyps and colorectal cancer in people over the age of 65.

As a result of these findings, the Colon Cancer Alliance and American College of Radiology are calling on Medicare to cover  virtual colonoscopy for seniors.

"Begin screening for colon cancer at age 50."

According to the Centers for Disease Control and Prevention, regular screenings of individuals 50 and older could save up to 30,000 lives. But about a third of these individuals never get testing for the 2nd leading cancer-related death in America. Screening rates for minorities are extremely low.

Having the option of virtual exams, which are essentially just scans, significantly increases participation, according to two studies conducted at National Naval Medical Center facilities in Bethesda, MD, and San Diego.

“The minimal invasiveness and lower cost of CT colonography can attract more seniors to be screened if Medicare will cover them for the exam," said Andrew Spiegel, Colon Cancer Alliance Chief Executive officer.

"Many seniors, who might not get tested otherwise, can’t afford the added cost of paying for the exam themselves and may ultimately pay with their lives if Medicare does not provide coverage,” Spiegel concludes.

Virtual colonoscopy uses low-dose X-rays to produce 3D moving pictures of the colon. It requires no sedation; people can resume normal activities immediately, and costs are substantially less than conventional exams.

“The 'out the door cost'” of a standard colonoscopy can often run about three times that of the CT colonography, once anesthesia and other associated charges are added,” Shawn Farley, MA, Director of Public Affairs for the American College of Radiology, told dailyRx.

The American Cancer Society endorses CT colonography, and a number of private insurers including CIGNA, UnitedHealthcare and Anthem Blue Cross Blue Shield cover virtual screenings. 

"Yet, Medicare refuses to cover seniors for this life-saving exam. All the while, thousands die needlessly each year from a disease that is nearly always treatable when caught early. This must change,” said Judy Yee, M.D., chair of the American College of Radiology Colon Cancer Committee.

The research study was published online February 23, 2012 in the journal Radiology.


Last Updated:
February 23, 2012