Department of Radiology, Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Boulevard, St Louis, MO 63110, USA.
Cancer Imaging. 2009 Oct 2;9 Spec No A(Special issue A):S59-62. doi: 10.1102/1470-7330.2009.9025.
Every year more than one million new patients are diagnosed with colon cancer worldwide. Although multiple prospective randomized trials and observational studies have demonstrated that mortality from colon cancer can be reduced with screening and removal of adenomatous polyps, compliance with screening guidelines remains low. Recent CT colonography (CTC) trials have shown that CTC is capable of demonstrating adenomatous polyps > or =10 mm (and in most cases > or = 6 mm) with sensitivities comparable to those for optical colonoscopy. Based on these results, at least two expert panels have recommended CTC as an option for colorectal cancer screening. Despite these endorsements, the Centers for Medicare and Medicaid Services (CMS) in the United States recently decided to deny coverage of CTC for colorectal cancer screening. This article addresses the reservations raised by CMS and provides a perspective on whether CTC is ready for routine use as a colorectal cancer screening test.
每年全世界有超过 100 万例新的结肠癌患者被确诊。尽管多项前瞻性随机试验和观察性研究表明，通过筛查和切除腺瘤性息肉可以降低结肠癌的死亡率，但对筛查指南的依从性仍然很低。最近的 CT 结肠成像（CTC）试验表明，CTC 能够显示出 > 或 = 10 毫米（在大多数情况下 > 或 = 6 毫米）的腺瘤性息肉，其敏感性与光学结肠镜检查相当。基于这些结果，至少有两个专家小组建议将 CTC 作为结直肠癌筛查的一种选择。尽管有这些认可，美国的医疗保险和医疗补助服务中心（CMS）最近决定拒绝为 CTC 用于结直肠癌筛查提供保险。本文将讨论 CMS 提出的保留意见，并就 CTC 是否准备好作为结直肠癌筛查测试常规使用提供一个视角。
