Skip to main content

Advertisement

SpringerLink
Log in

The Role of CT Colonography as a Screening Tool for Colorectal Cancer

  • Genetic Syndromes, Screening, and Surveillance in Colorectal Cancer (N Kubiliun, Section Editor)
  • Published:
Current Colorectal Cancer Reports

Abstract

Most colorectal cancers (CRC) are preventable through screening and polyp removal; however, CRC remains fixed as the second leading cause of cancer mortality in the USA. This is largely due to suboptimal screening participation. This review of current literature explores the use of CT colonography (CTC), also known as virtual colonoscopy, as another option for CRC screening. Relevant recent research topics include exploring the elimination of pre-procedure colon cleansing, the extension of recommended CTC screening intervals, the implications of extracolonic findings, and the significance of CTC radiation dose in a benefit/risk analysis. Peer-reviewed literature supports CTC as a viable option to safely screen average and moderate risk patients for CRC with polyps and cancer detection rates comparable to optical colonoscopy. CTC has the potential to raise CRC screening rates in population health management efforts.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Johnson CD, Chen MH, Toledano AY, Heiken JP, Dachman A, Kuo MD, et al. Accuracy of CT colonography for detection of large adenomas and cancers. N Engl J Med. 2008;359(12):1207–17. doi:10.1056/NEJMoa0800996

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Levin B, Lieberman DA, McFarland B, Andrews KS, Brooks D, Bond J, et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer, and the American College of Radiology. Gastroenterology. 2008;134(5):1570–95. doi:10.1053/j.gastro.2008.02.002.

    Article  CAS  PubMed  Google Scholar 

  3. •• Bibbins-Domingo K, Grossman DC, Curry SJ, Davidson KW, Epling JW, García FA, et al. Screening for Colorectal Cancer: US Preventive Services Task Force Recommendation Statement. JAMA. 2016;315(23):2564–75. doi:10.1001/jama.2016.5989. This statement by the US Preventive Services Task Force strongly recommends colon cancer screening for adults starting at age 50. The USPSTF also recommends CT colonography as a safe and beneficial screening exam in reducing the prevalence and mortality of colon cancer in the population.

    Article  CAS  PubMed  Google Scholar 

  4. Lieberman D. Colorectal cancer screening: practice guidelines. Dig Dis. 2012;30(Suppl 2):34–8. doi:10.1159/000341891.

    Article  PubMed  Google Scholar 

  5. Johnson CD, Herman BA, Chen MH, Toledano AY, Heiken JP, Dachman AH, et al. The National CT Colonography Trial: assessment of accuracy in participants 65 years of age and older. Radiology. 2012;263(2):401–8. doi:10.1148/radiol.12102177.

    Article  PubMed  PubMed Central  Google Scholar 

  6. •• Lin JS, Piper MA, Perdue LA, Rutter CM, Webber EM, O’Connor E, et al. Screening for colorectal cancer: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2016;315(23):2576–94. doi:10.1001/jama.2016.3332. This article reviews over 95 studies that have been conducted for CT screening information since the USPSTF published their original recommendation in 2008. The article reviews the test performance of CT colonography to optical colonoscopy and found that both exams provide equivalent results with CT colonography having little to no risk of serious adverse events. The article also evaluates the decreased radiation dose exposure in CT screening exams (approximately 1–5 mSv).

    Article  CAS  PubMed  Google Scholar 

  7. U.S. Food and Drug Administration. FDA requires new safety measures for oral sodium phosphate products to reduce risk of acute kidney injury. In: News & Events. U.S. Department of Health & Human Services, U.S. Food & Drug Administration. 2008. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/2008/ucm116988.htm. Accessed Feb 9 2017.

  8. Pooler BD, Baumel MJ, Cash BD, Moawad FJ, Riddle MS, Patrick AM, et al. Screening CT colonography: multicenter survey of patient experience, preference, and potential impact on adherence. AJR Am J Roentgenol. 2012;198(6):1361–6. doi:10.2214/AJR.11.7671.

    Article  PubMed  PubMed Central  Google Scholar 

  9. McFarland EG, Fletcher JG, Pickhardt P, Dachman A, Yee J, McCollough CH, et al. ACR Colon Cancer Committee white paper: status of CT colonography 2009. J Am Coll Radiol. 2009;6(11):756–772 e4. doi:10.1016/j.jacr.2009.09.007.

    Article  PubMed  Google Scholar 

  10. Almond LM, Bowley DM, Karandikar SS, Roy-Choudhury SH. Role of CT colonography in symptomatic assessment, surveillance and screening. Int J Color Dis. 2011;26(8):959–66. doi:10.1007/s00384-011-1178-8.

    Article  Google Scholar 

  11. ACR Colon Cancer Committee of the Comission on General Small and Rural Practice. Practice Parameter for the Performance of Computed Tomography (CT) Colonography in Adults (Resolution 2). In: The Process for Developing ACR Practice Parameters and Technical Standards. American College of Radiology Diagnostic Radiology: Computed Tomography (CT) Practice Parameters and Technical Standards. 2014. https://www.acr.org/~/media/ACR/Documents/PGTS/guidelines/CT_Colonography.pdf. Accessed January 16 2017.

  12. Rex DK, Johnson DA, Anderson JC, Schoenfeld PS, Burke CA, Inadomi JM, et al. American College of Gastroenterology guidelines for colorectal cancer screening 2009 [corrected]. Am J Gastroenterol. 2009;104(3):739–50. doi:10.1038/ajg.2009.104.

    Article  PubMed  Google Scholar 

  13. Pickhardt PJ, Kim DH, Pooler BD, Hinshaw JL, Barlow D, Jensen D, et al. Assessment of volumetric growth rates of small colorectal polyps with CT colonography: a longitudinal study of natural history. Lancet Oncol. 2013;14(8):711–20. doi:10.1016/S1470-2045(13)70216-X.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lieberman D, Moravec M, Holub J, Michaels L, Eisen G. Polyp size and advanced histology in patients undergoing colonoscopy screening: implications for CT colonography. Gastroenterology. 2008;135(4):1100–5. doi:10.1053/j.gastro.2008.06.083.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Yoo TW, Park DI, Kim YH, Kim HS, Kim WH, Kim TI, et al. Clinical significance of small colorectal adenoma less than 10 mm: the KASID study. Hepato-Gastroenterology. 2007;54(74):418–21.

    PubMed  Google Scholar 

  16. Butterly LF, Chase MP, Pohl H, Fiarman GS. Prevalence of clinically important histology in small adenomas. Clin Gastroenterol Hepatol. 2006;4(3):343–8. doi:10.1016/j.cgh.2005.12.021.

    Article  PubMed  Google Scholar 

  17. Zalis ME, Barish MA, Choi JR, Dachman AH, Fenlon HM, Ferrucci JT, et al. CT colonography reporting and data system: a consensus proposal. Radiology. 2005;236(1):3–9. doi:10.1148/radiol.2361041926.

    Article  PubMed  Google Scholar 

  18. Kim DH, Pickhardt PJ. Colorectal cancer: managing diminutive polyps-what is the optimal approach? Nat Rev Gastroenterol Hepatol. 2011;8(3):129–31. doi:10.1038/nrgastro.2011.19.

    Article  PubMed  Google Scholar 

  19. •• Pickhardt PJ, Pooler BD, Mbah I, Weiss JM, Kim DH. Colorectal findings at repeat CT colonography screening after initial CT colonography screening negative for polyps larger than 5 mm. Radiology, 2017. 282(1):139–48. doi:10.1148/radiol.2016160582. Pickhardt’s article supports the evidence based screening interval of 5–10 years for screening patients receiving a negative initial CTC screening exam. The article also supports the non-reporting management strategy for diminutive lesions since cancer rates are very low in these lesions.

  20. Pooler BD, Kim DH, Lam VP, Burnside ES, Pickhardt PJ. CT Colonography Reporting and Data System (C-RADS): benchmark values from a clinical screening program. AJR Am J Roentgenol. 2014;202(6):1232–7. doi:10.2214/AJR.13.11272.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Lieberman DA, Weiss DG, Bond JH, Ahnen DJ, Garewal H, Chejfec G. Use of colonoscopy to screen asymptomatic adults for colorectal cancer. Veterans Affairs Cooperative Study Group 380. N Engl J Med. 2000;343(3):162–8. doi:10.1056/NEJM200007203430301.

    Article  CAS  PubMed  Google Scholar 

  22. •• Yee J, Chang KJ, Dachman AH, Kim DH, EG MF, Pickhardt PJ, et al. The added value of the CT colonography reporting and data system. J Am Coll Radiol. 2016;13(8):931–5. doi:10.1016/j.jacr.2016.04.031. Several experts in the field of CT colonography express their support of C-RADS as a first step towards a standardized reporting system for the assessment and management strategy of colonic and extracolonic findings with the potential to evolve. The acceptance of C-RADS and E-RADS has been adapted for the ACR’s CTC National Data Registry with the potential of broad acceptance.

    Article  PubMed  Google Scholar 

  23. Cash BD, Riddle MS, Bhattacharya I, Barlow D, Jensen D, del Pino NM, et al. CT colonography of a Medicare-aged population: outcomes observed in an analysis of more than 1400 patients. AJR Am J Roentgenol. 2012;199(1):W27–34. doi:10.2214/AJR.11.7729.

    Article  PubMed  Google Scholar 

  24. Regge D, Iussich G, Senore C, Correale L, Hassan C, Bert A, et al. Population screening for colorectal cancer by flexible sigmoidoscopy or CT colonography: study protocol for a multicenter randomized trial. Trials. 2014;15:97. doi:10.1186/1745-6215-15-97.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Goldstein NS. Clinical significance of (sessile) serrated adenomas: another piece of the puzzle. Am J Clin Pathol. 2005;123(3):329–30. doi:10.1309/8H7M-UH9E-T9U2-1R2E.

    Article  PubMed  Google Scholar 

  26. Kim DH, Matkowskyj KA, Lubner MG, Hinshaw JL, Munoz Del Rio A, Pooler BD, et al. Serrated polyps at CT colonography: prevalence and characteristics of the serrated polyp Spectrum. Radiology. 2016;280(2):455–63. doi:10.1148/radiol.2016151608.

    Article  PubMed  Google Scholar 

  27. • Coppola F, Regge D, Flor N, Papadopoulos D, Golfieri R. Flat lesions missed at conventional colonoscopy (CC) and visualized by CT colonography (CTC): a pictorial essay. Abdom Imaging. 2014;39(1):25–32. doi:10.1007/s00261-013-0052-2. This study evaluates the experience of false negative findings incurred with conventional colonoscopy that were simultaneously positively identified by CT colonography and confirmed with a second endoscopy. Coppola finds CT colonography is comparable to colonoscopy as a screening exam.

    Article  PubMed  Google Scholar 

  28. Sakamoto T, Mitsuzaki K, Utsunomiya D, Matsuda K, Yamamura S, Urata J, et al. Detection of flat colorectal polyps at screening CT colonography in comparison with conventional polypoid lesions. Acta Radiol. 2012;53(7):714–9. doi:10.1258/ar.2012.110685.

    Article  PubMed  Google Scholar 

  29. Pickhardt PJ, Lam VP, Weiss JM, Kennedy GD, Kim DH. Carpet lesions detected at CT colonography: clinical, imaging, and pathologic features. Radiology. 2014;270(2):435–43. doi:10.1148/radiol.13130812.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Park SH, Lee SS, Choi EK, Kim SY, Yang SK, Kim JH, et al. Flat colorectal neoplasms: definition, importance, and visualization on CT colonography. AJR Am J Roentgenol. 2007;188(4):953–9. doi:10.2214/AJR.06.0436.

    Article  PubMed  Google Scholar 

  31. • Utano K, Nagata K, Honda T, Mitsushima T, Yasuda T, Kato T, et al. Diagnostic performance and patient acceptance of reduced-laxative CT colonography for the detection of polypoid and non-polypoid neoplasms: a multicenter prospective trial. Radiology. 2017;282(2):399–407. doi:10.1148/radiol.2016160320. This study evaluates the comparable diagnostic accuracy in neoplasms larger than 6 mm and the increased patient acceptance rate for reduced-laxative CT colonography. Utano also discusses CT colonography as an efficient triage examination for patients with a positive FIT. Higher patient acceptance can lead to increased screening rates and detection of colonic neoplasms.

    Article  PubMed  Google Scholar 

  32. Iafrate F, Iussich G, Correale L, Hassan C, Regge D, Neri E, et al. Adverse events of computed tomography colonography: an Italian National Survey. Dig Liver Dis. 2013;45(8):645–50. doi:10.1016/j.dld.2013.02.020.

    Article  PubMed  Google Scholar 

  33. Borden ZS, Pickhardt PJ, Kim DH, Lubner MG, Agriantonis DJ, Hinshaw JL. Bowel preparation for CT colonography: blinded comparison of magnesium citrate and sodium phosphate for catharsis. Radiology. 2010;254(1):138–44. doi:10.1148/radiol.09090398.

    Article  PubMed  Google Scholar 

  34. Keedy AW, Yee J, Aslam R, Weinstein S, Landeras LA, Shah JN, et al. Reduced cathartic bowel preparation for CT colonography: prospective comparison of 2-L polyethylene glycol and magnesium citrate. Radiology. 2011;261(1):156–64. doi:10.1148/radiol.11110217.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Cai W, Kim SH, Lee JG, Yoshida H. Informatics in radiology dual-energy electronic cleansing for fecal-tagging CT colonography(1). Radiographics. 2013;33(3):891–912. doi:10.1148/rg.333125039.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Cai W, Yoshida H. Electronic cleansing in CT colonography: past, present, and future. In: Yoshida H, Cai W, editors. Virtual Colonoscopy and Abdominal Imaging. Computational Challenges and Clinical Opportunities: Second International Workshop, Held in Conjunction with MICCAI 2010, Beijing, China, September 20, 2010, Revised Selected Papers. Berlin, Heidelberg: Springer Berlin Heidelberg; 2011. p. 1–8.

  37. Mahgerefteh S, Fraifeld S, Blachar A, Sosna J. CT colonography with decreased purgation: balancing preparation, performance, and patient acceptance. AJR Am J Roentgenol. 2009;193(6):1531–9. doi:10.2214/AJR.09.2342.

    Article  PubMed  Google Scholar 

  38. Zalis ME, Blake MA, Cai W, Hahn PF, Halpern EF, Kazam IG, et al. Diagnostic accuracy of laxative-free computed tomographic colonography for detection of adenomatous polyps in asymptomatic adults: a prospective evaluation. Ann Intern Med. 2012;156(10):692–702. doi:10.7326/0003-4819-156-10-201205150-00005.

    Article  PubMed  Google Scholar 

  39. Jensch S, Bipat S, Peringa J, de Vries AH, Heutinck A, Dekker E, et al. CT colonography with limited bowel preparation: prospective assessment of patient experience and preference in comparison to optical colonoscopy with cathartic bowel preparation. Eur Radiol. 2010;20(1):146–56. doi:10.1007/s00330-009-1517-0.

    Article  PubMed  Google Scholar 

  40. Shinners TJ, Pickhardt PJ, Taylor AJ, Jones DA, Olsen CH. Patient-controlled room air insufflation versus automated carbon dioxide delivery for CT colonography. AJR Am J Roentgenol. 2006;186(6):1491–6. doi:10.2214/AJR.05.0416.

    Article  PubMed  Google Scholar 

  41. Burling D, Taylor SA, Halligan S, Gartner L, Paliwalla M, Peiris C, et al. Automated insufflation of carbon dioxide for MDCT colonography: distension and patient experience compared with manual insufflation. AJR Am J Roentgenol. 2006;186(1):96–103. doi:10.2214/AJR.04.1506.

    Article  PubMed  Google Scholar 

  42. Pendsé DA, Taylor SA. Complications of CT colonography: a review. Eur J Radiol. 2013;82(8):1159–65. doi:10.1016/j.ejrad.2012.04.011.

    Article  PubMed  Google Scholar 

  43. Stoop EM, de Haan MC, de Wijkerslooth TR, Bossuyt PM, van Ballegooijen M, Nio CY, et al. Participation and yield of colonoscopy versus non-cathartic CT colonography in population-based screening for colorectal cancer: a randomised controlled trial. Lancet Oncol. 2012;13(1):55–64. doi:10.1016/S1470-2045(11)70283-2.

    Article  PubMed  Google Scholar 

  44. Fletcher JG, Silva AC, Fidler JL, Cernigliaro JG, Manduca A, Limburg PJ, et al. Noncathartic CT colonography: image quality assessment and performance and in a screening cohort. AJR Am J Roentgenol. 2013;201(4):787–94. doi:10.2214/AJR.12.9225.

    Article  PubMed  PubMed Central  Google Scholar 

  45. An S, Lee KH, Kim YH, Park SH, Kim HY, Kim SH, et al. Screening CT colonography in an asymptomatic average-risk Asian population: a 2-year experience in a single institution. AJR Am J Roentgenol. 2008;191(3):W100–6. doi:10.2214/AJR.07.3367.

    Article  PubMed  Google Scholar 

  46. Cardis E, Vrijheid M, Blettner M, Gilbert E, Hakama M, Hill C, et al. Risk of cancer after low doses of ionising radiation: retrospective cohort study in 15 countries. BMJ. 2005;331(7508):77. doi:10.1136/bmj.38499.599861.E0.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  47. Brenner DJ, Hall EJ. Computed tomography—an increasing source of radiation exposure. N Engl J Med. 2007;357(22):2277–84. doi:10.1056/NEJMra072149.

    Article  CAS  PubMed  Google Scholar 

  48. The American Association of Physicists in Medicine. Mission, Policies & Procedures. In: AAPM. The American Association of Phisicists in Medicine. 2016. http://aapm.org/. Accessed January 17 2017.

  49. • Lambert L, Danes J, Jahoda J, Masek M, Lisy J, Ourednicek P. Submilisievert ultralow-dose CT colonography using iterative reconstruction technique: a feasibility study. Acta radiologica. 2015;56(5):517–25. This study demonstrates the potential for radiation doses in CT colonography to be less than 1 mSv in both prone and supine imaging acquisitions. Decreased risk and increased benefits for patient safety is essential in an efficient CT colonography screening program.

    Article  PubMed  Google Scholar 

  50. Chang KJ, Yee J. Dose reduction methods for CT colonography. Abdom Imaging. 2013;38(2):224–32. doi:10.1007/s00261-012-9968-1.

    Article  PubMed  Google Scholar 

  51. Berrington de González A, Kim KP, Knudsen AB, Lansdorp-Vogelaar I, Rutter CM, Smith-Bindman R, et al. Radiation-related cancer risks from CT colonography screening: a risk-benefit analysis. AJR Am J Roentgenol. 2011;196(4):816–23. doi:10.2214/AJR.10.4907.

    Article  PubMed  Google Scholar 

  52. Pickhardt PJ, Kim DH, Meiners RJ, Wyatt KS, Hanson ME, Barlow DS, et al. Colorectal and extracolonic cancers detected at screening CT colonography in 10,286 asymptomatic adults. Radiology. 2010;255(1):83–8. doi:10.1148/radiol.09090939.

    Article  PubMed  Google Scholar 

  53. •• Pooler BD, Kim DH, Pickhardt PJ. Potentially important extracolonic findings at screening CT colonography: incidence and outcomes data from a clinical screening program. AJR American journal of roentgenology. 2016;206(2):313–8. doi:10.2214/AJR.15.15193. Pooler writes in support of the E-RADS reporting system and the necessity of follow-up for category E4 findings that could prove to be clinically significant. Although uncommon, extracolonic findings increase the patient’s standard of care and can aid in the surveillance or treatment of once unknown findings.

    Article  PubMed  Google Scholar 

  54. •• Plumb AA, Boone D, Fitzke H, Helbren E, Mallett S, Zhu S, et al. Detection of extracolonic pathologic findings with CT colonography: a discrete choice experiment of perceived benefits versus harms. Radiology. 2014;273(1):144–52. doi:10.1148/radiol.14131678. This article demonstrates patient and provider tolerance for extracolonic findings in order to diagnose an occasional malignancy. Thus, strengthening the need for a standardized reporting system such as E-RADS.

    Article  PubMed  Google Scholar 

  55. von Wagner C, Ghanouni A, Halligan S, Smith S, Dadswell E, Lilford RJ, et al. Patient acceptability and psychologic consequences of CT colonography compared with those of colonoscopy: results from a multicenter randomized controlled trial of symptomatic patients. Radiology. 2012;263(3):723–31. doi:10.1148/radiol.12111523.

    Article  Google Scholar 

  56. Zafar HM, Yang J, Harhay M, Lev-Toaff A, Armstrong K. Predictors of CT colonography utilization among asymptomatic medicare beneficiaries. J Gen Intern Med. 2013;28(9):1208–14. doi:10.1007/s11606-013-2414-4.

    Article  PubMed  PubMed Central  Google Scholar 

  57. •• Pyenson B, Pickhardt PJ, Sawhney TG, Berrios M. Medicare cost of colorectal cancer screening: CT colonography vs. optical colonoscopy. Abdom Imaging. 2015;40(8):2966–76. doi:10.1007/s00261-015-0538-1. Pyenson evaluates the cost effectiveness of CT colonography screenings when compared to optical colonoscopy. Lower expenses for Medicare patients can increase screening rates for colon cancer.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Christie J, Itzkowitz S, Lihau-Nkanza I, Castillo A, Redd W, Jandorf L. A randomized controlled trial using patient navigation to increase colonoscopy screening among low-income minorities. J Natl Med Assoc. 2008;100(3):278–84.

    Article  PubMed  Google Scholar 

  59. Percac-Lima S, Grant RW, Green AR, Ashburner JM, Gamba G, Oo S, et al. A culturally tailored navigator program for colorectal cancer screening in a community health center: a randomized, controlled trial. J Gen Intern Med. 2009;24(2):211–7. doi:10.1007/s11606-008-0864-x.

    Article  PubMed  Google Scholar 

  60. Lasser KE, Murillo J, Lisboa S, Casimir AN, Valley-Shah L, Emmons KM, et al. Colorectal cancer screening among ethnically diverse, low-income patients: a randomized controlled trial. Arch Intern Med. 2011;171(10):906–12. doi:10.1001/archinternmed.2011.201.

    Article  PubMed  Google Scholar 

  61. Dietrich AJ, Tobin JN, Robinson CM, Cassells A, Greene MA, Dunn VH, et al. Telephone outreach to increase colon cancer screening in medicaid managed care organizations: a randomized controlled trial. Ann Fam Med. 2013;11(4):335–43. doi:10.1370/afm.1469.

    Article  PubMed  PubMed Central  Google Scholar 

  62. • American Cancer Society. Medicare Coverage for Colorectal Cancer Testing. In: Medicare Coverage for Cancer Precention and Early Detection. American Cancer Society, Cancer Screening Guidelines. 2017. https://www.cancer.org/healthy/find-cancer-early/cancer-screening-guidelines/medicare-coverage-for-cancer-prevention-and-early-detection.html. Accessed Jan 21 2017. The ACS provides coverage information for Medicare patients in different areas. Low financial costs beared by the patient can lead to increased colon cancer screening rates.

  63. American College of Radiology. Private Payer Coverage. In: CT Colonography Resources American College of Radiology https://www.acr.org/Quality-Safety/Resources/CTC-Resources. Accessed Jan 21 2017.

  64. U.S. Department of Health & Human Services. 15 Covered Preventive Services for Adults. In: Preventive Services Covered Under the Affordable Care Act. U.S. Department of Health & Human Services. 2010. https://www.hhs.gov/healthcare/facts-and-features/fact-sheets/preventive-services-covered-under-aca/#. Accessed Jan 21 2017.

  65. • Centers for Medicare & Medicaid Services. Local Coverage Determination (LCD): Virtual Colonoscopy (CT Colonography) (L34055). Centers for Medicare & Medicaid Services. 2015. https://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=34055&ver=4&Date=&DocID=L34055&bc=iAAAABAAAAAAAA%3d%3d&. Accessed Jan 21 2017. Medicare services continues to deny coverage for CTC studies unless an attempted optical colonoscopy or a patient safety issue prevents a successful colonoscopy screening. Allowing multiple options for patients to choose from can lead to increased rates and compliance with screening programs.

Download references

Author information

Authors and Affiliations

  1. UT Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-8896, USA

    Vasantha Vasan & Cecelia Brewington

Authors
  1. Vasantha Vasan
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Cecelia Brewington
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Cecelia Brewington.

Ethics declarations

Conflict of Interest

Vasantha Vasan declares that she has no conflict of interest.

Cecelia Brewington is a member of the CT Colonography Committee for the American College of Radiology.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Genetic Syndromes, Screening, and Surveillance in Colorectal Cancer

Electronic supplementary material

Video 1

Real time fly-through CT colonography (MP4 26503 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Vasan, V., Brewington, C. The Role of CT Colonography as a Screening Tool for Colorectal Cancer. Curr Colorectal Cancer Rep 13, 293–301 (2017). https://doi.org/10.1007/s11888-017-0378-1

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11888-017-0378-1

Keywords

Search

Navigation