CT Colonography as Accurate as Standard Colonoscopy in Seniors

Computerized tomographic colonography (CTC), or virtual colonoscopy, is just as accurate as standard colonoscopies in detecting cancer and precancerous polyps in people aged 65 years and older, according to a study published in the journal Radiology.

CTC is less invasive than standard colonoscopies and patients do not require sedation, making CTC a more acceptable option for many people who may be avoiding standard colonoscopies out of preference or because of other medical issues.

Researches recruited 2,600 people over the age of 50 who had no symptoms of colorectal cancer. There were 499 patients who were 65 years or older and 477 were evaluable by study end. Large polyps were detected in 6.9 percent in the over 65 group, compared with 3.7 percent in the 50 to 65 year group.

The study findings back up an earlier study, published in the New England Journal of Medicine in 2008, which found CTC could be used effectively in colorectal cancer screening in adults 50 years old and over. With both these studies in hand, the Colon Cancer Alliance and American College of Radiology are now calling on Medicare to expand coverage for the procedure to seniors. CMS has refused to approve coverage, citing the lack of positive data in this age group.

“CT colonography is a perfectly viable colorectal cancer screening tool for the traditional Medicare age population. Wider availability made possible by Medicare coverage of CT colonography would attract more seniors to be screened for colorectal cancer – which is so successfully treated when detected early. Making CT colonography more available to seniors ultimately could save lives,” said C. Daniel Johnson, MD, of the Mayo Clinic in Scottsdale, Ariz., principal investigator of the National CT Colonography Trial, and lead author of the paper.

Several insurances do endorse and cover virtual colonoscopies in seniors, said Judy Yee, MD, chair of the American College of Radiology Colon Cancer Committee. “Yet, Medicare refuses to cover seniors for this life saving exam,” she said.

The Centers for Disease Control and Prevention estimate that regular colorectal screening of people over the age of 50 years could prevent up to 30,000 colorectal cancer deaths each year.