Is there sufficient MDCT capacity to provide colorectal cancer screening with CT colonography for the U.S. population?

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.