CMS's Landmark Decision on CT Colonography — Examining the Relevant Data

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Abstract
In an unprecedented endorsement of evidence-based medicine, the Centers for Medicare and Medicaid Services (CMS) recently decided to deny coverage of computed tomographic (CT) colonography for cancer screening, concluding that “the evidence is inadequate.”1 The CMS emphasized that the “pivotal, overarching concern” in its decision was the fact that the findings of trials showing a benefit of screening with this method were not necessarily generalizable from the study populations to other groups of patients. In particular, the CMS noted that the mean age of participants in the studies that were cited in support of coverage was significantly lower than that of Medicare beneficiaries. There were no studies evaluating this technology in the elderly, nor were there analyses of subgroups of participants over 65 years of age.