The US Preventive Services Task Force recently released its draft recommendations for colorectal cancer screening, with the notable omission of computed tomography as a recommended screening tool. Citing a lack in “the maturity of the evidence” and “gaps in evidence on incidental findings” for CT colonography, the report drew disappointment from various professional societies.
“It is disappointing USPSTF disregarded the abundance of evidence showing that CT colonography is a better, more patient-friendly alternative to traditional optical colonoscopy,” said Patrick Hope, executive director of Medical Imaging & Technology Alliance (MITA). “Colon cancer screening is already dramatically underutilized, and we believe greater acceptance of CT colonography would likely increase access to early detection and life-saving treatment. It is our hope that upon review of our comments, USPSTF will endorse CT colonography for colon cancer screening.”
The decision to exclude CT colonography “may be a significant blow to efforts to raise colorectal cancer screening rates,” wrote the American College of Radiology in a prepared statement. “This exclusion may result in countless unnecessary deaths and unnecessary health care spending.”
“This USPSTF draft recommendation could restrict access to a major tool to help achieve the National Colorectal Cancer Roundtable goal of an 80 percent colorectal cancer screening rate by 2018. As a result, thousands may continue to die each year that could be saved through more widespread screening enabled by CT colonography,” said Judy Yee, MD, chair of the ACR Colon Cancer Committee.
CT colonography uses low-dose X-rays to produce three-dimensional images of the colon. Compared to the traditional optical exam, CT colonography is less invasive and does not require sedation.
Colon cancer is the second-leading cause of cancer-related deaths in the United States, despite having a 90 percent cure rate when detected early.
A recent study in Abdominal Imaging shows that screening Medicare patients with CT colonography would cost 29 percent less than with optical colonoscopy and save up to $1.7 billion per screening cycle. At least a third of those who should be screened for CRC are not getting tested because they can’t have or don’t want a colonoscopy. Studies also show that CT colonography availability significantly boosts CRC screening rates which can detect more cancers early – when most treatable — and save lives.
Additionally, the USPSTF omitted from its recommended list the Cologuard fecal immunochemical DNA stool test (FIT-DNA), which was previously approved for coverage by the Centers for Medicare & Medicaid Services.
The Task Force is accepting public comment and feedback until November 2.
