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ISSUE TALKING POINTS
H.R. 1298, the CT Colonography Screening for Colorectal Cancer Act of 2017

Colorectal cancer is one of the leading causes of cancer death in the United States. While Medicare
pays for several colorectal cancer screening procedures, including optical colonoscopy, it does not
currently cover CT Colonography (CTC). Commonly referred to as “virtual colonoscopy,” studies
have proven that CTC is equally as effective and comparable in cost to optical colonoscopy.

Colorectal cancer is almost always curable when caught early enough through colorectal cancer
screening. Unfortunately, screening rates for colorectal cancer are just below 60% in most parts of
the country. A contributing factor to poor patient screening rates may be the invasiveness of standard
optical colonoscopies. Inclusion of the minimally invasive CTC as a colorectal cancer screening test
under Medicare could increase compliance rates among those eligible for the exam.

CTC is an American Cancer Society approved screening test and is covered by private payers in 37
states and the District of Columbia.

In 2016, the USPSTF released their final recommendations for colon cancer screening. In an
unprecedented move, the Task Force proposed an “A” grade for colon cancer screening for adults
between the ages of 50 and 75. It did not assign a specific grade to any particular screening tool,
instead acknowledging that there is no “one-size-fits-all” approach to colorectal cancer screening and
encourages informed, individual decision making. CTC is listed as a colon cancer screening option.

The bill(s) have not been scored by the Congressional Budget Office (CBO), however, data indicates
that CTC is less expensive per procedure than optical colonoscopy.

House Request- Please cosponsor H.R. 1298, the CT Colonography Screening for Colorectal Cancer
Act of 2017 (introduced by Reps. Brad Wenstrup (R-OH) and Danny Davis (D-IL). *If your House
Member is already a cosponsor of H.R. 1298, simply thank them for their continued support.

Senate Request-Currently, no Senate companion bill has been introduced. *Senators Jim Inhofe
(R-OK) and Bill Nelson (D-FL) have served as the lead sponsors on past Senate bills
Preserve Patient Access to Early Detection Cancer Screens

Countless studies indicate that timely diagnoses often play an integral role in patients’ survival,
recovery, and eventual quality of life after being afflicted with cancer.

Section 2713 of PPACA requires individual and group (employer) insurance plans to provide certain
preventive screening tests, as determined by a variety of agencies and advisory bodies, including the
United States Preventive Services Task Force (USPSTF), the Centers for Disease Control and
Prevention (CDC), and the Health Resources and Services Administration (HRSA), to beneficiaries
free from out of pocket costs.

Radiologists play a key role in early disease detection, providing some of the most well-known
preventive screening services, including mammograms for breast cancer, low dose CT (LDCT) lung
cancer screens, and CT Colonography (CTC) for colon cancer. Under Section 2713 of PPACA,
private insurance is required to provide these three imaging cancer screens without any form of
patient cost-sharing.

Universal access to preventive screens leads to improved patient outcomes, is fiscally responsible
because it leads to diseases being treated in their most affordable stage, and is consistent with other
major tenets of quality health care.

Congress continues to debate a variety of legislative approaches to repealing and replacing the Patient
Protection and Affordable Care Act, however, there is no consensus on a specific legislative
approach.

House and Senate Request- Senators and Representatives are urged to preserve access to preventive
screening as afforded by Section 2713 of PPACA, which requires private insurance companies to
provide screening services that are reviewed and approved by select federal agencies and advisory
bodies.

House and Senate Request- Federal elected officials are encouraged to remember that any form of
cost-sharing presents a sizable barrier to accessing life-saving screening services, especially within
low-income communities.
National Institutes of Health Funding

The ACR has long advocated for strong funding of the NIH. Most recently, the ACR-supported
legislation passed by Congress in December 2016, specifically the 21st Century Cures Act, which
authorized $4.8 billion of new NIH funding for projects such as the Cancer Moonshot, the Precision
Medicine Initiative and the Brain Research through Advancing Innovative Neurotechnologies
(BRAIN) Initiative.

However, the ACR is concerned with the Trump Administration’s initial 2018 Fiscal Year (FY)
budget proposal which calls for a $5.8 billion reduction in funding for the National Institutes of
Health (NIH), or nearly 20 percent below current funding levels.

If applied proportionally across the NIH, funding for the National Cancer Institute (NCI) would be
cut by nearly $1 billion. Similar cuts to smaller institutes, such as the National Institute of
Biomedical Imaging and Bioengineering (NIBIB), would be severely impacted by a 20 percent
funding decrease.

NIH has long played an irreplaceable role in new or improved treatments and diagnostics for a wide
range of diseases, leading to life saving benefits to patients and their families. By supporting research
at universities, medical schools, teaching hospitals and other institutions across the country, NIH has
fueled local and regional economies by creating jobs and catalyzing new industries.

ACR urges Congress to reject proposed cuts to NIH and instead finalize a spending package with
$34.1 billion for NIH, as approved by the Senate Appropriations Committee in June 2016, and
continue this budget trajectory with a $2 billion increase over fiscal year 2017 for NIH in fiscal year
2018, in addition to funds included in the 21st Century Cures Act for targeted initiatives.