More providers offer virtual colonoscopy, anticipating CMS coverage
Until recently, the accuracy of CTC in detecting polyps has been questioned, partly because results varied widely in tests at different centers. However, a recent large study conducted at 15 U.S. medical centers by the American College of Radiology Imaging Network (ACRIN), and sponsored by the National Cancer Institute (NCI), has convinced more medical professionals of the test's effectiveness, the Wall Street Journal (WSJ) reported.
The results, published in the Sept. 18 issue of New England Journal of Medicine, “provide evidence that CTC is approximately as successful as standard colonoscopy in the detection of colonic polyps,” the study’s co-author Robert Halvorsen Jr., professor of radiology at Virginia Commonwealth University's School of Medicine, told the WSJ. “It is also much easier for patients, does not require the patient to be sedated, miss a full day of work, or have someone to drive them home.”
Radiologists expect more insurers to start covering the virtual procedure for routine cancer screening. However, the WSJ said that patients undergoing the virtual test will still need a standard colonoscopy if suspicious polyps are found.
Many physicians expect the new study to help push the Centers for Medicare & Medicaid Services (CMS) to start covering virtual colonoscopies as soon as next year, a move that private insurers are likely to follow, according to WSJ. The agency said its coverage review is set for completion in February.
Meanwhile, some medical centers are getting ready for increased demand, the WSJ reported. While the procedures are generally performed on the same equipment used for other CT scans, the centers must acquire specialized computer software to perform CTC and train radiologists to read the results. The tests also could provide radiology departments in hospitals and clinics with additional new revenue.
Some medical centers also are rearranging work schedules so that when a radiologist is performing a CT colonography, a gastroenterologist is available in case the patient needs polyps removed; the NEJM study found this occurs among 17 percent of patients.
A proper colon screening service should offer same-day polyp removal because patients should not be forced to endure the distasteful laxative preparation a second time, Richard Obregon, a radiologist at Invision Sally Jobe, a radiology group in Denver, told the WSJ. Such coordinated scheduling is already practiced with other screenings, such as mammography programs that offer immediate diagnostic tests.