CT colonography the most cost-effective cancer screening option for many
New research suggests that computed tomography colonography may be the most cost-effective colorectal cancer screening option for some patients.
In January 2025, the Centers for Medicare and Medicaid services lent their support for CTC as a screening tool for the disease. The exam is now covered for eligible individuals at average risk the same way colonoscopies and fecal immunochemical tests are. Experts were hopeful expanded coverage would translate to greater screening adherence, as CTC exams are noninvasive and easily accessible.
New findings from the Neiman Health Policy Institute and Northwell Health indicate CTC may be especially beneficial for black adults, a traditionally underserved demographic in screening settings.
“We found that CTC was the most cost-effective screening strategy for black adults, both men and women. As such, CTC delivers strong value for black adults, who face unique barriers to traditional screening,” study author Pina C. Sanelli, MD, MPH, vice chair of research at Northwell Health, said in a news release on the findings.
Sanellia and colleagues conducted a simulation analysis that takes into account real-world screening adherence for all covered colorectal cancer screening options. Using data spanning 2010 to 2019, the group compared both the medical and financial outcomes of five different screening options: (1) status quo (choice between colonoscopy and fecal testing); (2) CTC every 5 years; (3) colonoscopy every 10 years; (4) annual fecal testing; and (5) multitarget stool DNA test every 3 years, plus no screening. These data were used to calculate lifetime costs, quality-adjusted life years gained and incremental cost-effectiveness ratios in white and black adults.
The status quo option yielded more cancer cases among black adults, though this group more often opted for fecal screening. The CTC strategy resulted in more quality-adjusted life years and fewer cancer cases in black adults, with the opposite effect observed in white adults. CTC was found to be the most preferred option among black adults as well, suggesting an opportunity for increased uptake of the exam now that coverage has been widely implemented, the group advised.
“CMS should be applauded for expanding Medicare coverage to include CT colonography, which we show is superior to colonoscopy and stool-based tests for reducing disparities in black Americans,” noted study co-author Elizabeth Rula, PhD, executive director at the Neiman Institute. “Physicians and insurance providers should channel these promising results into efforts to increase colorectal cancer screening rates by expanding the use of CTC.”
Read more about the findings here.
In addition to her background in journalism, Hannah also has patient-facing experience in clinical settings, having spent more than 12 years working as a registered rad tech. She began covering the medical imaging industry for Innovate Healthcare in 2021.