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Is There Sufficient MDCT Capacity to Provide Colorectal Cancer Screening with CT Colonography for the U.S. Population?

¹ Department of Radiology, University of Wisconsin Medical School, E3/311 Clinical Science Center, 600 Highland Ave., Madison, WI 53792-3252.
² Department of Radiology, Uniformed Services University of the Health Sciences, Bethesda, MD.
³ Gastroenterology and Digestive Endoscopy Unit, "Nuovo Regina Margherita" Hospital, Rome, Italy.
⁴ Department of Radiological Sciences, University of Rome La Sapienza "Policlinico Umberto I," Rome, Italy.

OBJECTIVE. The impact of introducing widespread colorectal cancer (CRC) screening with CT colonography (CTC) on current resource capacity is unknown. Although a relatively large number of MDCT scanners are currently in operation throughout the United States, these existing units already perform studies for a wide array of indications. Our aim was to assess the ability of the available MDCT capacity in the United States to provide population screening with CTC.

MATERIALS AND METHODS. Mathematic and Markov models were used to assess the mean number of CTC procedures per MDCT scanner per day (expressed as CTC/MDCT/day) necessary for both the startup and steady-state phases of a nationwide screening effort. Plausible ranges were applied to a number of variables in the sensitivity analysis. The number of existing CT scanners in the United States was based on 2006 estimates.

RESULTS. At baseline analysis, assuming gradual increases in compliance, CTC penetrance (percentage of screening-compliant population who would opt for CTC), and MDCT capacity, a total of 37,227,541 adults would need to undergo CTC screening over a 10-year startup period, corresponding to 1.2–1.6 CTC/MDCT/day. Assuming a 5-year routine screening interval between the ages of 50 and 80 years, the number of CTC studies needed to be performed in the steady-state period is 1.2 CTC/MDCT/day. These estimates were sensitive to variations in compliance, MDCT capacity, population size, interval for the startup phase, and the routine CTC screening interval.

CONCLUSION. CT capacity in the United States appears to be adequate for handling the potential demand related to mass population screening with CTC, even without assuming a specific CTC-driven increase in MDCT supply.

Keywords: CT • CT colonography • MDCT • screening • virtual colonoscopy

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