If a virtual colonoscopy is an appropriate screening tool for arguably the
most important patient U.S. Navy physicians will see all year, then
shouldn't it be good enough for Grandma and Grandpa?
That's what radiologists have been saying since President Obama on Feb. 28
received his first routine physical exam as commander-in-chief at the
National Naval Medical Center in Bethesda, Md. During the exam, Obama
received a virtual colonoscopy, also known as a CT colonography. But
administration officials at the Centers for Medicare & Medicaid Services
last year denied coverage of the same exam for Medicare beneficiaries,
limiting access to a screening that advocates say is as accurate as a
standard colonoscopy and much less invasive for the patient.
"We are pleased that the president is in good health and that he and his
doctors have embraced CT colonography's ability to accurately detect
colorectal cancer," said Judy Yee, MD, chair of the American College of
Radiology's Colon Cancer Committee. "The fact that the leader of the free
world has chosen to be screened with this exam is a testament that CTC
works as a front-line colorectal cancer screening."
Many health insurers, including Cigna, UnitedHealthcare, and Anthem
BlueCross and BlueShield, now cover CT colonography exams for their
beneficiaries, the ACR pointed out in a March 2 letter to the president.
Colorectal cancer is the third most common cancer diagnosed in the U.S. and
the second-leading cause of cancer death, despite having a 90% cure rate
when detected early. Fewer than half of those age 50 and older who should
be screened for the disease opt to receive the traditional exams currently
covered by Medicare, but that could change if the alternative treatment
were covered, the college stated.
CT colonography does not require sedation, and it uses x-ray technology to
create three-dimensional, fly-through images of the colorectal structure.
In a final coverage decision in May 2009, CMS stated there wasn't enough
evidence to demonstrate that it's an appropriate screening test, and it
cited studies showing that the technology is less effective at early
detection of certain kinds of polyps.
A memo outlining the results of Obama's examination is available online
(www.whitehouse.gov/sites/default/files/rss_viewer/potus_med_exam_feb2010.pdf).
The full and original article can be found here:
http://www.ama-assn.org/amednews/2010/03/15/gvsg0318.htm
