The U.S. Preventive Services Task Force (USPSTF) has issued a grade of "A" to CT colon cancer screening of adults between ages 50 and 75. The task force's position is expected to result in full Medicare coverage of exams for patients in that age group — and private insurers are expected to follow suit.

CT colonography (CTC) was listed as one of seven acceptable options for colorectal cancer screening in the expert panel's final recommendations, which were published Wednesday in JAMA.

Besides CTC, it also approved of flexible sigmoidoscopy, the guaiac-based fecal occult blood test, the fecal immunochemical test, the multitargeted stool DNA test, and the methylated SEPT9 DNA test for reducing the incidence of and mortality from colorectal cancer or all-cause mortality.
The variety of screening options may bring an element of personalized care and patient comfort to a screening process that has been historically met with some resistance. Last May, a study from the CDC found that only 25 percent of uninsured people and 60 percent of insured people were being screened for colon cancer as recommended.

“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,” Dr. William T. Thorwarth, FACR, CEO of the American College of Radiology, said in a statement.

The task force also evaluated the harms of the seven screening options and the test performance characteristics of the tests for detecting adenomatous polyps, advanced adenomas based on size, or both, as well as colorectal cancer. It also commissioned a comparative modeling study to provide information on optimal starting and stopping ages and screening intervals across the different available screening methods.

Last September, MITA published a study illustrating that CT colonography is a cost-effective colorectal cancer screening option for the Medicare population. “CT colonography presents a cost-effective alternative to optical colonoscopy and is effective at early detection of colon cancer, a deadly disease which is very costly to treat,” Patrick Hope, executive director of MITA, told HCB News at that time.

The USPSTF's previous 2008 recommendations stated that people ages 50 to 75 should be screened with either a colonoscopy, one of two stool analyses or flexible sigmoidoscopy combined with fecal occult blood test. CTC, which uses a low-dose radiation CT scan to see the inside of the colon, is among the new additions to that list from USPSTF.

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