Courtney C. Moreno, MD, Chair of the American College of Radiology® (ACR®) CT Colonography Registry Committee, and ACR Colon Cancer Committee member, contributed this post.
On Feb. 2, 2022, President Biden announced a relaunch of the Cancer Moonshot Program with a goal of reducing the death rate from cancer by at least 50% over the next 25 years and placed renewed focus on cancer screening rates and closing gaps in cancer screening. As March is National Colorectal Cancer Awareness Month, what better time for radiologists to educate ourselves, our colleagues and our patients on the current state of colorectal cancer screening?
Colorectal cancer screening prevents cancer by detecting precancerous polyps before they can turn into cancer and also catches cancer earlier when it is still curable. The American Cancer Society recommends that average-risk individuals begin cancer screening at age 45.
Colorectal cancer screening recommendations from the United States Preventive Services Task Force (USPSTF) assigned an “A” grade to USPSTF-recognized screening exams, including CT Colonography (CTC). Average-risk individuals who select CTC as their screening test should undergo CTC every five years, whereas some of the stool-based tests need to be performed annually. Most patients who undergo CTC have a negative screening exam and can return for their next screening CTC in five years. Approximately 10% of patients who undergo screening CTC are referred to have an optical colonoscopy based on CTC findings.
Commercial insurance companies are required to cover CTC without cost sharing. However, Medicare still does not cover CTC for a screening indication. A recent article based on data from the ACR CTC Registry found that utilization of CTC in Black Americans dropped after age 65, suggesting that the lack of Medicare coverage may further contribute to decreased rates of screening amongst Black Americans. The ACR continues to advocate for a change in this Medicare non-coverage decision to expand access and ensure equitable care for all.
Additionally, rates of cancer screening across all groups dropped significantly during the COVID-19 pandemic, and now is the time to return to care. As radiologists, we can do our part to improve colorectal cancer screening rates by raising awareness of less invasive options like CTC and performing CTC for patients who request it.
Throughout this month and beyond, take advantage of ACR Colon Cancer Screening Resources to educate your patients and referring providers, including patient-friendly information about CTC and private payer coverage. In addition, register your facility in the My CT Colonography locator tool to help patients find your practice and get screened.Please share your thoughts in the comments section below and join the discussion on Engage (login required).