On February 11, 2009 the Centers for Medicare and Medicaid Services (CMS) issued a proposed national coverage decision memorandum not to pay for computed tomographic colonography (so-called virtual colonoscopy) to screen for colorectal cancer.

The evidence is inadequate to conclude that CT colonography is an appropriate colorectal cancer screening test under §1861(pp)(1) of the Social Security Act. CT colonography for colorectal cancer screening remains noncovered.

The national coverage decision will not be final until 30 days after February 11 to allow for public comments.  Individuals and organizations concerned about the proposed decision can submit a comment online. However, CMS does not now cover screening CT colonography.

IMPORTANT: If you want to submit a comment to CMS online, you MUST click on and open the CMS PHI Posting Policy and then check off that you have read it.  If you don’t click on the underlined link, you cannot enter a check mark, your personal information, or your comment. Read the rest of this entry »

One of the discussions at GI Symposium was whether virtual colonoscopy is ready for prime time. What is that? Well, it is a CT scan which evaluates the colon for polyps and other changes instead of using a scope to enter the colon and look directly.

It is often misunderstood that the preparation for these two procedures are different. They are not. You need a clean colon whether you get a CT colonoscopy or a real one. Read the rest of this entry »

CT colonography (so-called virtual colonoscopy or CTC) can also detect osteoporosis during colorectal cancer screening. Using the same images obtained while looking for colorectal polyps, a different software program can examine the spine for bone mineral density.  Low bone mineral density  is a symptom of osteoporosis which increases risk for broken bones. Read the rest of this entry »

With the addition of CT colonography (so-called virtual colonoscopy) to colorectal cancer screening guidelines, there is concern about whether or not to remove small polyps found during the CTC exam.

Large polyps are 10 millimeters or bigger, and doctors agree that people who have at least one large polyp discovered by CT colonography (CTC) should be referred for an optical colonoscopy to have them removed right away.  However, it isn’t clear whether or not small polyps larger than 5 millimeters but not yet 10 millimeters need to be removed.  Because most colorectal polyps develop slowly, it is enough to wait and repeat the CTC test in three years?

Using a decision model that analyzed key information about colorectal cancer risk and development, researchers found that when only small polyps are found, waiting to repeat the CTC in three years has the most benefit with the least risk and cost. Read the rest of this entry »

Computerized tomographic colonography (CTC), so-called virtual colonoscopy, proved accurate in locating colon polyps or cancers 10 millimeters or larger in a large study conducted in a number of community centers across the United States.  The x-ray-based test found 90 percent of l0 millimeter polyps identified by traditional colonoscopy, which uses a lighted tube inserted into the rectum to view the colon. Read the rest of this entry »