CT colonography screening: ready for prime time?
Every year more than one million new patients are diagnosed with colon cancer worldwide. Although multiple prospective randomized trials and observational studies have demonstrated that mortality from colon cancer can be reduced with screening and removal of adenomatous polyps, compliance with screening guidelines remains low. Recent CT colonography (CTC) trials have shown that CTC is capable of demonstrating adenomatous polyps > or =10 mm (and in most cases > or = 6 mm) with sensitivities comparable to those for optical colonoscopy. Based on these results, at least two expert panels have recommended CTC as an option for colorectal cancer screening. Despite these endorsements, the Centers for Medicare and Medicaid Services (CMS) in the United States recently decided to deny coverage of CTC for colorectal cancer screening. This article addresses the reservations raised by CMS and provides a perspective on whether CTC is ready for routine use as a colorectal cancer screening test.
Heiken
Jay P
JP
Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, St Louis, MO 63110, USA. heikenj@mir.wustl.edu
D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000517:prevention & control; D000236:Adenoma / Q000000981:diagnostic imaging*; D018256:Adenomatous Polyps / Q000000981:diagnostic imaging; D000368:Aged; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging* / Q000517:prevention & control; D003111:Colonic Polyps / Q000000981:diagnostic imaging*; D023881:Colonography, Computed Tomographic / Q000009:adverse effects / Q000191:economics / Q000379:methods / Q000639:trends; D003113:Colonoscopy / Q000009:adverse effects; D005104:Expert Testimony; D006801:Humans; D019458:Insurance Coverage; D008403:Mass Screening; D008484:Medicaid; D006278:Medicare; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D010349:Patient Compliance; D017410:Practice Guidelines as Topic; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D014481:United States