Congress Introduces Bill to Include Virtual Colonoscopies under Medicare

Much to the pleasure of the medical imaging community, Congress has introduced a bill that would include virtual colonoscopy for colon cancer screening in Medicare.  In a statement released by the Medical Imaging and Technology Alliance, the group said that reimbursement for virtual colonoscopy can pave the way in eliminating unnecessary barriers to screening for colorectal cancer. Congress’s bill, called Virtual Screening for Colorectal Cancer Act or H.R. 4165, requires the Centers for Medicare and Medicaid Services (CMS) to pay back expenses for virtual colonoscopy screening.  Virtual colonoscopy uses a CT scan of the stomach and intestines to come up with a 3D image of the entire colon for physicians to examine for any abnormalities like polyps or tumors.

H.R. 4165 is sponsored by Republican Representative from Texas Ralph Hall and Democratic Representative from Illinois Danny K. Davis. Davis released a statement on his website stating that introduction of the bill is timely because March is officially National Colorectal Cancer Awareness month.

CMS did not cover virtual colonoscopy in 2009 due to lack of evidence that the procedure that is appropriate for patients old enough to be covered by Medicare.  But current research has indicated that such screening is essential for those over 65 years old. One such study released said that analyzing the precision of CT colonography in locating polyps determined that virtual colonoscopy is just as effective among this age group as among younger adults between 50 and 65, which was established in the 2008 by the American College of Radiology Imaging Network. Researchers from Mayo Clinic, particularly lead investigator C. Daniel Johnson, M.D., said that they found no significant difference in the tests’ diagnostic performance between the two age groups. 

Advocates of virtual colonoscopy believe that this method can increase recommended screening compliance.  The Lancet published that patients who were offered virtual screening demonstrated 55% higher compliance rates than those who were offered the traditional colonoscopy procedure.  However, there is a downside to the virtual colonoscopy procedure, the root of which lies in cost-effectiveness. Though virtual colonoscopy can immediately detect abnormalities, most growths found during a scan will still have to be removed during traditional colonoscopy. During the older procedure, the polyp or a tumor sample can be taken as soon as it is found with the colonoscope.  Another argument states that virtual colonoscopy can mistakenly detect extra-colonic findings as growths that must be sampled or biopsied, which can induce unnecessary costs.

Concern that a low percentage of Americans are getting screened and much too many are dying from colon cancer is growing. The American College of Physicians commented that 60% of citizens over 50 are not getting tested for colon cancer as is recommended—a staggering statistic.  It is expected that the bill will encourage more individuals who are of screening age to schedule a virtual colonoscopy. Early detection of precancerous polyps increases the chances of successful treatment and prolonged life. For a more thorough comparison of virtual colonoscopy and standard colonoscopy, visit your local GI doctor.