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Abdominal Imaging

, Volume 40, Issue 8, pp 2966–2976

First Online: 09 September 2015


Purpose: To compare the Medicare population cost of colorectal cancer CRC screening of average risk individuals by CT colonography CTC vs. optical colonoscopy OC. Methods: The authors used Medicare claims data, fee schedules, established protocols, and other sources to estimate CTC and OC per-screen costs, including the costs of OC referrals for a subset of CTC patients. They then modeled and compared the Medicare costs of patients who complied with CTC and OC screening recommendations and tested alternative scenarios. Results: CTC is 29% less expensive than OC for the Medicare population in the base scenario. Although the CTC cost advantage is increased or reduced under alternative scenarios, it is always positive. Conclusion: CTC is a cost-effective CRC screening option for the Medicare population and will likely reduce Medicare expenditures for CRC screening.

KeywordsCT colonography Optical colonoscopy Medicare Costs Cost-effectiveness AbbreviationsACRAmerican College of Radiology

ACGAmerican College of Gastroenterologists

ACSAmerican Cancer Society

AGAAmerican Gastroenterological Association

ASGEAmerican Society for Gastrointestinal Endoscopy

CMSCenters of Medicare and Medicaid Services

CPT®Current procedural terminology, a registered trademark of the American Medical Association AMA

CRCColorectal cancer

CTCCT colonography

HCPSHealthcare common procedure coding system

HOPDHospital outpatient department


OCOptical colonography

OPPSOutpatient prospective payment system

USPSTFUS Preventative Services Task Force

Electronic supplementary materialThe online version of this article doi:10.1007-s00261-015-0538-1 contains supplementary material, which is available to authorized users.

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Autor: Bruce Pyenson - Perry J. Pickhardt - Tia Goss Sawhney - Michele Berrios


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