Radiology societies seek Medicare coverage for CT colonography

June 24, 2008

Several radiology-related professional societies have joined forces to urge the Centers for Medicare and Medicaid Services to approve national Medicare coverage for CT colonography to screen patients for colorectal cancer.

Several radiology-related professional societies have joined forces to urge the Centers for Medicare and Medicaid Services to approve national Medicare coverage for CT colonography to screen patients for colorectal cancer.

The American College of Radiology, the Society of Gastrointestinal Radiologists, and the Society of Computed Body Tomography and Magnetic Resonance sent CMS a joint comment letter June 18 requesting reimbursement for CTC providers. The document states that there are sufficient data and clinical evidence to support the claim.

The comment letter cites recent American Cancer Society guidelines, which add CTC to the ACS list of recommended options for colorectal cancer screening. The guidelines, developed jointly with the ACR and the U.S. Multi-Society Task Force on colorectal cancer, emphasize cancer prevention as the primary goal of colorectal screening. The new ACS rules contend there is compelling evidence of CTC's preventive value for average-risk patients 50 years and older.

The letter also points out recent research data showing CTC's viability as a screening option, including the ACR's Imaging Network National CT Colonography Trial (ACRIN 6664). The ACRIN study found CTC compares favorably with colonoscopy, the current gold standard for screening.

"The trial concludes that CTC accurately detects colorectal neoplasia among average-risk persons and that broad application of this relatively noninvasive technique as a primary test option appears highly feasible and may serve to enhance compliance with current colorectal cancer screening recommendations," the letter said.

The document bears the signatures of ACR executive director Dr. Harvey L. Neiman, SGR president Dr. Richard M. Gore, and SCBT-MR past president Dr. Jeffrey C. Weinreb.

The letter provides CMS with an overview of more than a decade's worth of clinical trials leading to CTC's validation, including direct comparisons between CTC and colonoscopy. It also mentions the current clinical practice guidelines observed by CTC providers, including appropriateness criteria, quality and safety assurance, and radiation dose.

In separate sections, the letter to CMS also offers a glance at the cost-effectiveness of the CT-based screening procedure, the patient population best suited for the test, and its future enhancement with accuracy-boosting technologies such as computer-aided detection.

For more information from the Diagnostic Imaging archives:

CMS commences national coverage analysis for CT colonography

CT colonography experts plan for growing demand

CAD provides value in spotting difficult 'flat' colonic lesions

CT installed base can handle demand for colon cancer screening