Newer is not always better. Evidence is important. Simple themes, oft forgotten in health journalism.
Back in October, an Atlanta Journal-Constitution story talked of the wonders of virtual colonoscopy, saying it replaced the dreaded colonoscope and lessened patient risk. It used these words to refer to the technology: "science fiction, Star Wars, video game, Disney World."
Also in October, the Wall Street Journal promoted the growing popularity of virtual colonoscopies.
Neither story mentioned the fact that the U.S. Preventive Services Task Force had stated that same month that "The evidence is insufficient to assess the benefits and harms of computed tomographic colonography as a screening modality for colorectal cancer."
Last week's announcement that Medicare may stop paying for virtual colonoscopies also got little news attention. At least the New York Times reported it. Excerpts:
The Centers for Medicare and Medicaid Services said in a decision posted on its Web site that there was "insufficient evidence" to conclude that virtual colonoscopy "improves outcomes in Medicare beneficiaries."
...the United States Preventive Services Task Force, which advises the government on prevention, said last year that there was insufficient evidence to assess the benefits and harms of the CT technique. Some private insurers pay for the tests; others do not.
In its analysis, Medicare said many studies supporting virtual colonoscopy were done in people with a mean age around 58, so results might not fully apply to Medicare's older population.
For instance, older people are more likely to have polyps. So the proportion of people who would have to have a conventional colonoscopy after a virtual one would be greater. That would make the CT scan less cost-effective.