March 9, 2009 - At a Capitol Hill briefing, colorectal screening experts said today that Medicare should reimburse physicians for virtual colonoscopy so that seniors have access to this minimally-invasive screening test, adding another valuable tool for detecting and preventing colorectal cancer.
In February, CMS proposed a coverage decision to deny reimbursement for computed tomography colonography (CTC). The comment period ends March 13. The American Cancer Society, American College of Radiology, Colon Cancer Alliance and Medical Imaging & Technology Alliance participated in the briefing before Congress on colorectal cancer screening.
“Virtual colonoscopies, which are less invasive than traditional colonoscopies, but very effective in detecting polyps and cancers, can be a more appealing option for elderly patients who might otherwise decline screening,” said Andrew Spiegel, CEO, Colon Cancer Alliance. “Without access to alternative methods of testing, many seniors will make the detrimental decision to forgo screening. The difference between being screened and not can be the difference between life and death. Medicare should cover CTC screenings.”
Today’s speakers also discussed the barriers that prevent increased colon cancer screening rates, especially among seniors, non-white and low-income populations. They also focused on the importance of increasing colon cancer screenings and highlighted important technologies that aid in the detection of colon cancer, including virtual colonoscopy.
“When used appropriately, virtual colonoscopy saves lives and money by increasing screening and early detection,” said Ilyse Schuman, managing director of the Medical Imaging & Technology Alliance. “Colorectal cancer can be cured if caught early, making it all the more important to make the virtual colonoscopy screening option available to America’s seniors.”
Appropriateness criteria, which was included as a pilot project in last year’s Medicare bill, will ensure medical imaging is utilized effectively, without compromising patients’ access to the scans they need. And peer-reviewed research demonstrates that appropriateness criteria works. A recent study published in the Journal of Radiology conducted by researchers at the University of Florida Health Center and Massachusetts General Hospital demonstrates the clear benefit of using appropriateness criteria to help curb growth rates in advanced imaging utilization.
The briefing not only focused on the pending CMS coverage decision, but also featured a patient testimonial from Newark, Delaware, resident Rosemarie Blair, who spoke about the value of virtual colonoscopy and how it saved her life. After avoiding a colonoscopy for a decade, Blair finally scheduled a virtual colonoscopy after a family friend passed away from colon cancer. Her virtual colonoscopy detected polyps that were removed, and the technology also found kidney cancer that would otherwise have gone undiagnosed – ultimately saving her life.
“Stories like Rosemarie’s are a true testament to the power of medical imaging in preventing and detecting colon cancer,” said Spiegel. “Without access to noninvasive methods of testing, many seniors will make the terrible decision to forgo screening. In Rosemarie’s case, her decision to have a virtual colonoscopy saved her life.”
March is Colorectal Cancer Awareness Month, and more than 140,000 Americans are diagnosed with colorectal cancer every year with nearly 50,000 dying because it is detected too late. Colorectal cancer is the third most frequently diagnosed cancer and the second leading cause of cancer death in both men and women in the United States, despite having a 90 percent cure rate when detected early. By increasing the use of established screening tests, a great majority of these cancers and deaths could be prevented.
Colonoscopies can detect polyps and colon cancer early, but only about half of the people aged 50 and older who should get one actually do. In standard colonoscopy, a thin, tube-like probe with a camera on its end is snaked through the rectum and colon. Virtual colonoscopy uses non-invasive CT scans, capturing images of the inner wall of the colon to detect abnormal growths called polyps and early signs of colon cancer.
Last year, a definitive study published in the New England Journal of Medicine, using data from the American College of Radiology Imaging Network, found virtual colonoscopies to be as effective as traditional methods. Virtual colonoscopies are also included in the American Cancer Society's list of recommended screening exams for the early detection and prevention of colorectal cancer for adults age 50 years and older.
In a study set to be published in the American Journal of Radiology, University of Wisconsin’s Department of Radiology professor, Perry Pickhardt, M.D., and a team of researchers concluded that because of CTC’s ability to simultaneously screen for both colorectal cancer and abdominal aortic aneurysm, it is a “highly cost-effective and clinically efficacious screening strategy for the Medicare population.”
Speakers for this event included J. Leonard Lichtenfeld, M.D., MACP, Deputy chief medical officer, national office of American Cancer Society; Beth McFarland, M.D., chair of Colon Cancer Committee, American College of Radiology; Ilyse Schuman, managing director, Medical Imaging & Technology Alliance; Andrew Spiegel, CEO, Colon Cancer Alliance; Amy Patrick, M.D., managing partner, Mid-Atlantic GI Consultants and; Mark J. Baumel, M.D., MS, founder, president and CEO, Colon Health Centers of America, LLC.