CT Colonography Comparable to Standard Colonoscopy in Those Ages 65 Years and Older

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(ChemotherapyAdvisor) – No significant differences were found in CT colonography diagnostic accuracy between those younger and older than 65 years of age who underwent the procedure, post-hoc analysis of National CT Colonography trial data published in Radiology online February 23 have shown.

Based on these results, the Colon Cancer Alliance, American College of Radiology, and the Medical Imaging & Technology Alliance are now calling on Medicare to cover the costs of CT colonography in Medicare-eligible recipients in this age group. Data are consistent with the 2008 study results published in the New England Journal of Medicine for adults ages 50 years and older; however, in that analysis, participants ≥65 years were not specifically examined. Citing lack of data, the Centers for Medicare and Medicaid Services has deferred coverage for CT colonography.

Of 2,600 asymptomatic participants in the study, 497 were ≥65 years; complete data were available for 477. Prevalence of adenomas 1cm or larger for the older participants was 6.9% vs. 3.7% for the younger participants. For large neoplasms, mean estimates for CT colonography sensitivity and specificity were 0.82 and 0.83, respectively, for the older group and 0.92 and 0.86 for the younger group; per-polyp sensitivity for large neoplasms was 0.75 for the older population and 0.84 for the younger population.  

“For the older and younger groups, per-participant sensitivity was 0.72 and 0.81 for detecting adenomas 6mm in diameter or larger,” the investigators found. These data “support CT colonography as a primary colorectal cancer screening tool for all eligible patients.”


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