The researchers said if virtual colonoscopies convinced an additional 25 percent of otherwise unscreened people to get a scan, it would be cost-effective at the current rate of $488. If only 10 percent extra were encouraged, it would be cost-effective at $204 to $408, the authors said.

Currently, there's no evidence CTC scan availability increases screening compliance, Knudsen said.


In an accompanying editorial, Dr. Russell Harris, professor of medicine at UNC and a member of UNC Lineberger Comprehensive Cancer Center, said while the analysis was useful, the models might actually overestimate the cost-effectiveness of both screening tests. For instance, colonoscopy often results in harmless polyps being removed, which can result in excessive bleeding, and CTC scans can detect abnormalities outside the colon, such as in the kidneys or liver, which lead to further testing and surgery even though the treatment will not help the patients live longer.

Harris said, in the end, neither test is ideal.

"Wouldn't it be interesting if we ended up, a few years from now, with neither CTC nor colonoscopy as the primary screening test, but rather an improved fecal test as our gold standard?" Harris asked.



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