CT Colonography Is a Viable Screening Test in Older Adults
(HealthDay News) – For older patients who undergo computed tomography colonography (CTC), the rates of referral to colonoscopy and prevalence of advanced neoplasia are low.
Brooks D Cash, MD, from the National Naval Medical Center in Bethesda, MD, and colleagues assessed the outcomes of 1,410 consecutive Medicare-eligible patients aged ≥65 years (mean age, 75 years; 83.5% white) who underwent screening or surveillance CTC between 2004 and 2009.
The researchers found that, based on a polyp size threshold of 6mm, the frequency of referral to colonoscopy was 14.5%. Colorectal neoplasia and advanced neoplasia were found in 9.3% and 3.3% of patients, respectively. In 2.9% of patients, potentially important extracolonic findings were observed.
"These results provide previously unavailable information regarding outcomes associated with CTC in older patients and should be considered carefully by policy makers when making coverage and public health implementation decisions regarding CTC screening for the Medicare-eligible population," the authors write. "We believe that CTC screening and surveillance for colorectal cancer in Medicare-aged patients is a viable alternative to other tests and should be reconsidered for endorsement by both the U.S. Preventive Services Task Force and Centers for Medicare & Medicaid Services."