Insurance coverage of CT colonography and other USPSTF-recognized tests could help fight CRC

Final United States Preventive Services Task Force (USPSTF) colorectal cancer screening recommendations assigned an "A" grade to colorectal cancer (CRC) screening in those ages 50-75 years and provided a list of recognized screening exams. The Affordable Care Act would now require private insurers to fully cover (with no co-pay) all of these USPSTF-recognized CRC screening exams - including CT colonography (virtual colonoscopy). Medicare should now recognize this overall "A" grade and provide full coverage for CT colonography.

"As the USPSTF agreed, the best test is one that patients will actually use. A third of those who should be screened for colorectal cancer still choose not to be tested. Patients need more fully-covered screening options if we are going to reduce colorectal cancer deaths. Private insurers and Medicare should now fully cover virtual colonoscopy and the other USPSTF-recognized exams," said William T. Thorwarth, MD, FACR, chief executive officer of the American College of Radiology.

Virtual colonoscopy is an American Cancer Society-recommended screening exam that has been shown in studies in the United States and abroad to increase screening rates where offered. Virtual colonoscopy has been proven comparably accurate to colonoscopy in most people of screening age — including those ages 65 and older. President Obama received a virtual colonoscopy in his first checkup as Commander-in-Chief.

A recent major study shows that screening Medicare patients with CT colonography would reduce CRC screening costs by 29 percent and save Medicare up to $1.7 billion per screening cycle. CIGNA, UnitedHealthcare, Anthem Blue Cross Blue Shield and many other insurers cover screening virtual colonoscopy. More than 20 states require insurers to cover these exams. Today's USPSTF recommendations, under the Affordable Care Act, would now require all private insurers who take part in insurance exchanges to cover beneficiaries for CTC and the other USPSTF-recognized tests.

"Mandatory insurance coverage of CT colonography and the other USPSTF-recognized exams is a major step forward in the battle against colorectal cancer. Medicare coverage for CT colonography would remove a financial barrier to this screening and enable more seniors to be screened. This would help prevent many cancers, find more cancers before they progress and save thousands of people who might otherwise die from a disease that is often preventable. Medicare needs to follow through on this USPSTF "A" grading for the USPSTF-recognized exams," said Judy Yee, MD, chair of the American College of Radiology Colon Cancer Committee.