Mission

ICER's mission is to lead innovation in comparative effectiveness research through methods that integrate considerations of clinical benefit and economic value.  Through a unique collaboration with patients, clinicians, manufacturers, insurers and other healthcare stakeholders, ICER develops tools to support patient decisions and medical policy that share the goal of achieving maximum value for every healthcare dollar.

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CT Colonography

Computed tomography colonography (CT colonography or CTC) is a minimally invasive radiological technique used to provide images of the colon and rectum. CTC has been suggested as an alternative or as complementary to conventional colonoscopy and other population-based screening methods for colorectal cancer. Given that only 40%-60% of eligible patients undergo recommended screening for colorectal cancer, some commentators have suggested that the speed and relative ease of CTC compared to conventional colonoscopy might enhance patient compliance with screening recommendations. After more than a decade of research on CTC, however, questions remain about several important issues:

  1. The sensitivity and specificity of CTC compared to conventional colonoscopy
  2. Variation in performance across different providers and imaging modalities
  3. Likely impact of CTC on population screening rates
  4. Linkages between CTC and colonoscopy for removal of identified polyps
  5. The impact on outcomes and costs of incidental “extracolonic” findings
  6. Cost and cost-effectiveness of CTC

Given the possible benefits of introducing a widely available minimally-invasive option for colorectal cancer screening, there is considerable interest in CTC. That interest is colored by uncertainty over the evidence on the accuracy of CTC, and by questions about the potential impact broad adoption of CTC would have on systems of care and on health care costs. With these issues and questions in mind, ICER selected CTC as an important technology for which decision-makers would benefit from a thorough review of its clinical effectiveness and value compared to colonoscopy and other accepted screening methods for colorectal cancer.

 

Background Materials & Key Questions

CT Colonography Scoping Committee Agenda, Key Questions, and Overview

CTC Evidence Review Group

 

Mid-Cycle Review Documents

CTC Clinical Effectiveness Review Introductory Slides

CTC Systematic Review Slides

 

 Final Appraisal Documents

CTC Final Apprasial -- Executive Summary

CTC Final Appraisal -- Full Report 

 

Update Documents

September 2008 CTC Update 


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