Lack of insurance coverage remains obstacle to wider colorectal cancer screening with CT colonography

A recent questionnaire submitted to a group of patients at one of the nation's largest general hospitals suggests that a significant number of patients, who have previously refused colorectal cancer screening, are willing to undergo computed tomography colonography (CTC) (or virtual colonoscopy), but not willing to pay for the exam themselves when not covered by insurance, according to a study in the August issue of the American Journal of Roentgenology (www.ajronline.org). Noninvasive CTC is increasingly being considered for colorectal cancer screening. It uses CT imaging and computers to produce 2D and 3D images of the colon. Compared to conventional colonoscopies, CTC does not require sedation.

The study, performed at Massachusetts General Hospital in Boston, MA, included 68 patients who had been offered colorectal cancer screening. Patients participated in a questionnaire and were asked about their willingness to undergo CTC and about other relevant factors, such as fees. Patient's reasons for not being screened were also explored.

"After being informed about CTC screening, most (83 percent) subjects stated they would be willing to undergo a CTC study," said Chin Hur, MD, lead author of the study. "However, 70 percent stated they would not be willing to pay out-of-pocket fees if insurance did not cover the study, and even among the 30 percent who were willing to pay the fees, the average amount they were willing to pay (mean, $244; median, $150) was well below currently charged rates," said Hur.

"After being informed about CTC as a screening technique for colorectal cancer, the majority of currently nonadherent patients stated that they would be willing to have a CTC screening study, suggesting that CTC availability could improve screening rates," he said.

"However, the majority of participants were not willing to pay out-of-pocket expenses, and even among those who were willing, most were not willing to pay currently charged fees," said Hur. The currently charged rate is between $500 and $1500.

Source: American College of Radiology / American Roentgen Ray Society