Effectiveness debate over virtual colonscopies

Andrew Van Dam

About Andrew Van Dam

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

Officials are considering whether or not Medicare will cover virtual colonoscopies, a technology that, while cheaper and far less invasive, may also be less reliable. Los Angeles Times reporter Noam N. Levey looked at how the debate over colorectal screening illuminates the difficulties inherent in the larger discussion about the Obama administration’s push for efficient health-care spending.

According to Levey, “Colorectal cancer is highly treatable if detected early, but it remains the nation’s second deadliest cancer, in large part because half of adults over 50 do not get screened.” Levey reported that patients avoid screening primarily because they wish to avoid the sedation or discomfort that accompany the procedure.

Doctors and researchers do not yet agree on the effectiveness of virtual scanning, and it still requires unpleasant preparations like colon-cleansing and the insertion of air into the intestine. Nonetheless, it promises to offer a relatively enticing alternative to the traditional colonoscopy.

Some studies have indicated that the procedure can detect most polyps as well as traditional colonoscopy. But others have suggested it is not be as good at detecting some smaller polyps.

Disputes over the cost-effectiveness of virtual colonoscopy further complicated the analysis.

The agency’s extensive year-long review of the efficacy of virtual colonoscopy shows just how much budgetary pressure Medicare is under during a period of increased scrutiny and reform.

Medicare, which will spend more than $500 billion this year, is under increasing pressure to contain spending that many experts say threatens the whole federal budget.

Of particular concern has been the rising cost of scans. Medicare spent more than $14 billion on imaging in 2006, double what it spent six years earlier, according to a 2008 report by the Government Accountability Office.

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