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September 18, 2018

Inhofe, Sanders Introduce Bill to Provide CT Colonography Screening Under Medicare

U.S. Sens. Jim Inhofe (R-Okla.) and Bernie Sanders (I-Vt.) introduced legislation that would provide Medicare coverage for CT (virtual) Colongraphy (CTC) screening.

“Colorectal cancer is one of the leading causes of cancer deaths, but is one of the most preventable and treatable cancers if it is caught early. We need to encourage more Americans to get tested for this cancer early, but traditional screening methods are invasive and costly. Virtual colonoscopies, however, are less invasive, significantly more cost-effective and widely available across the country, but aren’t an option for Medicare beneficiaries. As colorectal cancer disproportionally affects individuals over the age of 70, Medicare should include virtual colonoscopies as an option to promote early detection and treatment,” Inhofe said. “In addition to significantly reducing costs, the use virtual colonoscopies as front line screening is supported by guidelines from the American Gastroenterology Association, the American Cancer Society and the American College of Radiology.”

“Colorectal cancer is the second most common cancer diagnosed in this country, and yet Medicare does not currently cover virtual colonoscopies which are far more convenient and can help detect colorectal cancer early on,” said Sanders. “If Medicare covered this screening– which this bill seeks to accomplish –– we would not only save billions of dollars, we would save tens of thousands of lives and help finally beat the colorectal cancer epidemic that kills thousands of Americans every year.”

This legislation is supported by the Prevent Cancer Foundation, Colorectal Cancer Alliance, Colon Cancer Coalition and the American College of Radiology Colon Cancer Committee.

“Medicare-covered access to CT colonography can attract many who would otherwise not be tested, allowing doctors to remove polyps before they become cancers and helping people prevent this deadly disease,” said Carolyn R. (“Bo”) Aldigé, CEO and founder of the Prevent Cancer Foundation.

"Timely screening for colorectal cancer can literally save lives, but there are many patients who either cannot or will not have a colonoscopy. For these patients, CT colonography provides a less invasive alternative. The Colorectal Cancer Alliance supports the bipartisan legislation introduced by Senator Inhofe that will make this screening option available through Medicare,” said Michael Sapienza, president and chief executive officer (CEO) of the Colorectal Cancer Alliance.

“Medicare coverage of virtual colonoscopy can help increase screening in underserved areas and reduce racial and ethnic disparities in colorectal cancer outcomes. All seniors should have covered access to the test that they will actually choose to have,” said Anne Carlson, president of the Colon Cancer Coalition. 

“CT Colonography is as accurate as standard colonoscopy  in most people — including those 65 and older — and is far less invasive. Former President Obama had this test. Medicare needs to cover CT colonography and help physicians save more lives,” said Judy Yee, MD, chair of the American College of Radiology Colon Cancer Committee.

According to the National Institutes of Health’s National Cancer Institute, in 2017 medical costs associated with colorectal cancer topped $16.3 billion, the second highest of all cancers. According to the American Cancer Society (ACS), Colorectal cancer (CRC) is the second most common cancer diagnosed in United States and the third leading cause of cancer death, even though it has a 90 percent cure rate with early detection. More than 140,000 Americans are diagnosed with CRC every year, and nearly 50,000 men and women die due to late detection.

A 2015 study estimated that, under Medicare’s fee schedule, the average cost of a colonoscopy screening is $1,035. In contrast, a diagnostic virtual colonoscopy (CTC) is $243.  

In 2008, the American Cancer Society (ACS), backed by the American Gastroenterology Association (AGA), and the American College of Radiology (ACR), recommended CTC as a front line screening exam for colorectal cancer screening for all people over the age of 50. Currently, in 31 states and Washington, D.C., commercial insurance carriers reimburse for CT colonography in accordance with the American Cancer society guidelines.

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