NEWARK, DEL. — With soothing walls of turquoise tile and a vase of orchids on the front desk, the Colon Health Center of Delaware has been selling an alternative to one of medicine's most unloved procedures -- the colonoscopy.
Rather than insert several feet of tubing into patients' lower intestines, clinicians slide patients into a computed tomography, or CT, imaging machine that can quickly scan the abdomen for signs of cancer.
Today, however, this procedure is the subject of a heated debate in Washington pitting powerful sectors of the healthcare industry against a government desperate to contain healthcare spending.
The fight over virtual colonoscopy has also become a prime example of how hard it can be to ensure that healthcare dollars are spent efficiently, a key goal of the Obama administration.
The procedure is cheaper and more comfortable than the traditional method. Proponents say the noninvasive approach will save lives by increasing the number of people who get screened. Around 50,000 people die every year from colorectal cancer, many because they avoided a traditional colonoscopy.
But there is still no consensus about the effectiveness of the new procedure. Some critics contend it could inflate the nation's skyrocketing healthcare tab because a traditional colonoscopy is required if anything is found in the imaging.
Federal officials are now deciding if Medicare should cover virtual colonoscopy for millions of senior citizens, a determination that could have consequences for all consumers, as well as doctors, hospitals and medical equipment makers. The decision is expected next month.
"This may be a bellwether for how the hard choices around expanding access and controlling costs will play out," said Dr. Sean Tunis, who was chief medical officer at the Centers for Medicare and Medicaid Services in the last Bush administration.
Colorectal cancer is highly treatable if detected early, but it remains the nation's second deadliest cancer, in large part because half of adults over 50 do not get screened.
For years, the most reliable screening method has been optical colonoscopy, in which an endoscope is used to inspect the walls of the intestine and remove abnormal growths, or polyps. But many people shy away from getting screened because they don't want to be sedated, as is sometimes necessary, or prodded by a tube inserted through the rectum.
