MEDICINE&SCIENCE
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The groups pushing for Medicare coverage of the relatively new procedure hope a recent decision by the United States Preventive Services Task Force to give virtual colonoscopies its highest safety rating could help their cause. The task force’s grade-A rating also now requires insurers that sell plans under the Affordable Care Act to pay for the screenings.
Those with private insurance in Maryland also have coverage of virtual colonoscopies, thanks to a state regulation adopted in 2008 requiring private insurers to cover the procedure. Adding Medicare coverage will expand the screening to those most at risk, supporters said.
“The best colorectal cancer screening exam is the one that a person chooses to use,” Eric Hargis, public policy adviser for the Colon Cancer Alliance, said in a statement. “Too many Americans are dying from a largely preventable disease that can almost always be treated if found early. Medicare coverage of virtual colonoscopy would ensure access to a proven screening method for those who cannot, or will not, have an optical colonoscopy. This will save lives.”
Despite the push, not all doctors believe virtual colonoscopies should be used in place of the traditional procedure.
Dr. Anurag Maheshwari, a gastroenterologist at Mercy Medical Center who specializes in liver disease, said he only recommends the virtual procedure under special circumstances, such as a blockage in the intestine. If you find polyps through the virtual procedure, a second procedure would have to be done to remove them, he said. Polyps can be removed during a traditional colonoscopy.
Nevertheless, Maheshwari thinks Medicare should cover virtual colonoscopies.
“It has its place in medicine and we do support coverage by Medicare because lack of coverage is the reason of underutilization of the procedure,” he said. “It definitely has a role to play to increase the number of patients who get colorectal screening.”
Patients who are at high risk for the disease — they have stool in the blood, or previous polyps — should stick to the traditional procedure, said Dr. Karen Horton, chair and professor of radiology and radiological science at the Johns Hopkins University School of Medicine.
Virtual colonoscopy “is really for the screening of average-risk patients,” she said.
Dr. Bruce Greenwald, a gastroenterologist with University of Maryland Medical Center, said there are pros and cons to both procedures, but that having more options to meet patient preference is a good thing.
“The most important thing is screening and figuring out the best screening tools for each individual,” Greenwald said.
Julia Hardison, 73, prefers virtual colonoscopy. She got her first one because of an obstruction in her colon. She felt a lot of discomfort that first time because doctors overinflated her intestines.
But now the retiree from Owings Mills is a convert. She got her third virtual procedure last week at Greater Baltimore Medical Center and said there is no turning back.
“I found it less invasive and less timeconsuming, and I didn’t have to take a drug for it,” she said.
“This will save lives.”
Eric Hargis, Colon Cancer Alliance