Stakeholders Urge Congress to Pass Screening Act for Colorectal Cancer

A number of colorectal cancer care advocacy groups and the American College of Radiology are lobbying Congress to pass the CT Colonography Screening for Colorectal Cancer Act, an initiative that could lower costs and increase screening rates.

Medicare coverage for the virtual colonoscopy would provide coverage for seniors who face financial barriers from private insurance companies when seeking this screening exam option. According to Eric Hargis, CEO of the Colon Cancer Alliance,¹a third of patients who should be screened for colorectal cancer (CRC) don’t have access or choose not to obtain screening.

CT colonography, a less invasive procedure where technicians employ low-dose radiation CT screening to acquire images of the interior of the colon,²has proved comparable in accuracy with colonoscopy in most people, specifically patients 65 years or older, and does not require sedation.¹Patients can return to their daily activities following the procedure.

Studies indicated that covering CT colonography in Medicare patients would cost 29% less than it would for optical colonoscopies and would save nearly $1.7 billion each screening cycle.³The study warned, however, that a CT colonography may provide a suboptimal assessment if the screening cannot provide a full, accurate picture. 

“Medicare coverage would provide seniors with insured access to an exam that may appeal to them. This would jump-start screening, catch more cancers early, and saves more lives,” said Hargis, in a statement.¹

More than 20 states require insurers to cover CRC screenings. CIGNA, UnitedHealthCare, Anthem Blue Cross Blue Shield, and other major insurers cover beneficiaries for the virtual screenings while Medicare still does not.

Many seniors who want a CT colonography have to pay for the exam out of pocket, on top of the annual Medicare premiums.¹Comparatively, the Affordable Care Act ensures that private insurers cover most exams given a grade A or B rating, meaning no co-pays. These exams generally include preventive services for diabetes, obesity, cholesterol, and various types of cancers like CRC.⁴

Michael Sapienza, president and founder of the Chris4Life Colon Cancer Foundation, said in a statement that providing Medicare coverage for virtual colonoscopies allows more patients to freely choose which procedure is best for them.¹As a result, he said that increased screening and early detection will prevent more extensive treatments down the road and can improve quality of life.

Many key stakeholders agreed that increased screenings due to lower costs and greater accessibility could essentially save lives.

“Medicare coverage for virtual colonoscopy would provide access to a proven test that more seniors may use. This is vital. CRC is one of the few cancers that we can often prevent. Detecting precancerous polyps can stop them from becoming cancer. This saves lives,” Carolyn R. (“Bo”) Aldigé, president and founder of the Prevent Cancer Foundation, added.¹

References

1. Patient and Provider Groups Call on Congress to Pass Medicare Virtual Colonoscopy Coverage [news release]. Washington, DC: American College of Radiology; November 11, 2015. http://www.acr.org/About-Us/Media-Center/Press-Releases/2015-Press-Releases/20151111-Patient-and-Provider-Groups-Call-on-Congress-to-Pass-Medicare-Virtual-Colonoscopy-Coverage. Accessed November 12, 2015.
2. Radiologyinfo.org. CT Colonography (Virtual Colonoscopy). What is CT colonography? http://www.radiologyinfo.org/en/info.cfm?pg=ct_colo. Accessed November 12, 2015.
3. Pyenson B, Pickhardt PJ, Sawhney TG, Berrios M. Medicare cost of colorectal cancer screening: CT colonography vs. optical colonoscopy. Abdominal Imaging. 2015;40(8):2966-2976. http://link.springer.com/article/10.1007/s00261-015-0538-1/fulltext.html. Accessed November 12, 2015.
4. Pollitz K, Lucia K, Keith K et al. Coverage of colonoscopies under the Affordable Care Act’s prevention benefit. National Colorectal Cancer Roundtable. 2015. http://nccrt.org/wp-content/uploads/NCCRT.pdf. Accessed November 13, 2015.