Abstract

Colorectal cancer (CRC) is a leading cause of cancer-related mortality worldwide, underscoring the critical need for effective screening. With the recent approval of CT virtual colonoscopy (CTC) for CRC screening by Medicare in the United States as of 2025, its utilization is anticipated to rise significantly. This review provides a timely update on the role of CTC, examining its benefits and limitations as a screening modality. CTC offers a less-invasive alternative to conventional colonoscopy, featuring a superior safety profile, no need for sedation, and the ability for patients to resume normal activities immediately, while also providing extraluminal evaluation of the abdomen and pelvis. However, several limitations persist, including reduced sensitivity for small (<10 mm) or flat lesions, exposure to low-dose radiation, and the necessity for a follow-up therapeutic colonoscopy if polyps are detected. The cost-effectiveness and insurance coverage for CTC also remain subjects of ongoing debate. Future directions involve leveraging artificial intelligence to improve polyp detection and focusing on patient-centered approaches to enhance screening adherence. In conclusion, CT virtual colonoscopy (CTC) is a valuable, less-invasive screening option for colorectal cancer, offering a strong safety profile and high patient acceptability. Despite several limitations. Its recent Medicare approval is set to increase its utilization. Successful integration into screening programs hinges on educating patients and providers about its appropriate role and benefits.

Keywords:CT Virtual Colonoscopy; CTC-Colorectal Cancer Screening

Abbreviations: CRC: Colorectal Cancer; CTC: CT Virtual Colonoscopy; CMS: Centers for Medicare and Medicaid Services; OPPS: Hospital Outpatient Prospective Payment System; PFS: Physician Fee Schedule; AI: Artificial Intelligence