Colonoscopy's new gold standard

Colorectal cancer is the second-leading cause of cancer death in the U.S., with more than 150,000 patients diagnosed and treated annually, spurring support of gastroenterologists for updated CRC screening guidelines.

On Aug. 22, the American College of Gastroenterology and the American Society for Gastrointestinal Endoscopy released updated recommendations on quality indicators for colonoscopies. The new guidelines highlight aspects of a colonoscopy that must be prioritized in order to provide the highest quality screening and catch more CRC cases earlier.

Other players in the GI space have vocalized support for these guidelines, including Olympus, a medical technology company. 

"We agree that current clinical standards must reflect the capabilities that have been enabled by novel techniques and technologies, including high-definition endoscopes that help drive quality improvements," Olympus said in a statement to Becker's. "Furthermore, this guidance opens new opportunities for level setting in situations of suboptimal performance, including the use of assistive devices and enhanced imaging technologies."

At the same time, the FDA gave clearance for the first cloud-based AI platform designed to detect colorectal polyps during colonoscopies. The Caddie, a computer-aided detection device, can improve early detection of colorectal cancer using AI software that can be remotely updated, according to a Sept. 5 news release

The success of Caddie was first demonstrated in a trial across eight medical centers in Europe, where it analyzed colonoscopy video in real time. 

While technological advances and updates to screening recommendations aim to increase the accuracy and effectiveness of colonoscopies, access to these procedures still presents an issue for many GI physicians, as reimbursement rates continue to decline and inflation weighs on practices nationwide. 

"My biggest concern is people moving away from getting colon screening due to shifts in payment from certain commercial insurances and CMS. Before, if a patient was to have a colonoscopy for screening, no matter what the findings were, the cost would be [100%] covered," Raquel Hernandez, Administrator of Laredo (Texas) Digestive Health Center, told Becker's.   

However, if a colonoscopy becomes diagnostic, patients can expect to pay 15% of the Medicare-approved amount for a physicians' services. In ASCs, patients may also pay a 15% coinsurance amount.

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