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Virtual Colonoscopy: Who Should Get It?

Doubts Remain About Usefulness in Patients at High Risk of Colorectal Cancer

Medicare Won’t Cover Virtual Colonoscopy

More than 14 million traditional colonoscopies are performed in the United States every year, but millions more people who could benefit from colorectal cancer screening are not getting it.

The American Cancer Society estimates that only about 40% of people over the age of 50 are getting any kind of screening for colon cancer.

Supporters of virtual colonoscopy say the noninvasive test could convince many of these people to get screened.

But those supporters were dealt a blow last month when it was announced that Medicare would no longer pay for the procedure.

Federal policy makers concluded that the evidence was not sufficient to prove that virtual colonoscopy "improves health benefits for asymptomatic, average risk Medicare beneficiaries."

American Cancer Society Chief Medical Officer Otis W. Brawley, MD, expressed disappointment in a written statement released soon after the decision was announced.

The American Cancer Society "still believes that a battery of different tests for colorectal cancer screening should be available to the American people," he writes.

Hated Bowel Prep Still Needed

In an editorial published with the study, Finlayson writes that it remains to be seen if clinicians are willing to accept the downsides of virtual colonoscopy if it means that more people will get screened.

But Rex says there is little evidence that patients would be more willing to have a virtual colonoscopy than a traditional one.

Both procedures require the same daylong, intensive bowel prep, which is what patients complain about most.

"The procedure itself is not what people hate. It's the prep," Rex says.

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