The largest study of the efficacy of virtual colonoscopy (computed tomographic colonography) in Americans ages 65 and older, published online Feb. 23 in Radiology, has confirmed the “virtual” exam is comparably effective to standard colonoscopy at detecting colorectal cancer and precancerous polyps in older seniors. Due to these results, as well as those of a 2008 study in the New England Journal of Medicine and the multitude of trials with similar positive outcomes since, organizations such as the Colon Cancer Alliance, American College of Radiology and the Medical Imaging & Technology Alliance (MITA) are calling on Medicare to cover seniors for virtual colonoscopy.
The Centers for Disease Control and Prevention (CDC) estimate that up to 30,000 colorectal cancer deaths each year could be prevented if all those age 50 and older were screened regularly. However, roughly one-third of those who should be screened for colorectal cancer do not get tested; this is particularly true among minorities, whose screening rates are much lower. Studies at National Naval Medical Center facilities in Bethesda, Md., and San Diego have shown that availability of the virtual exam significantly boosted colorectal cancer screening rates.
“The minimal invasiveness and lower cost of CT colonography can attract more seniors to be screened if Medicare will cover them for the exam. 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,” said Andrew Spiegel, CEO of the Colon Cancer Alliance.
"CMS has indicated it was waiting for data proving CT colonography is as effective as traditional colonoscopy for Medicare beneficiaries," said Gail Rodriguez, MITA executive director. "Now that there is definitive proof that a virtual colonoscopy is as effective as the optical exam for Medicare beneficiaries and it reduces barriers to colorectal cancer screenings, CMS should open a national coverage decision for CTC so that more American seniors have access to tools to diagnose colon cancer early when it's most treatable."
The “virtual” colonoscopy uses high-tech, low-dose X-rays to produce 3-D moving images of the colon. The virtual exam is far less invasive than standard colonoscopy, and does not require sedation.
For more information: www.ccalliance.org, www.acr.org
June 19, 2025 
