Colorectal Cancer Screening Before 65 Could Save Medicare Dollars

Screening people for colorectal cancer before they reach 65 and are eligible for Medicare could save millions of dollars of future Medicare costs according to a New York City study.

While Medicare covers the cost of screening colonoscopies, people need to be 65 to benefit.  Many uninsured adults from 50 to 64 have no way to get screened for colorectal cancer at all.

Dr. Jianjun Li and colleagues from Maimonides Medical Center in Brooklyn offered free colonoscopies to uninsured patients who were over 50 but too young for Medicare.  The average age of the 248 patients screened was 55.

Forty-five percent of patients had polyps, mostly small. However, 5 patients had early stage I or II cancer and 22 had large polyps, bigger than 1 centimeter.   Large polyps have the greatest risk of turning into cancer.

Without the free screening, most of the uninsured patients would have had to wait until they were 65 when Medicare would cover the costs.  Over ten years, the cancers would have progressed to costly advanced stages and large polyps might have developed into cancer.

The researchers estimate that if the cancers found during early screening and cancers that grew from large polyps had gone undetected until patients were 65, treatment would have cost Medicare $1,295,000. Based on current Medicare reimbursements, the estimated cost of the screening program and surgical treatment for the five early cancers was $390,000.  Early screening saved two dollars for every one dollar spent.

Results of the free screening program were announced at the annual scientific meeting of the American College of Gastroenterology in Orlando.

The team concluded,

A screening program for colon cancer in a patient population averaging 10 years prior to Medicare eligibility would save at least 2 dollars for every dollar spent. We recommend that the Federal Government screen patients for colon cancer earlier than when they become eligible for Medicare. This approach would prevent suffering and be cost-effective to the Federal Government.

Source: Badalov et al. Potential Savings For Federal Funding of a Colorectal Cancer Screening Program In Uninsured Patients, American College of Gastroenterology Annual Scientific Meeting 2008, October 6, 2008.

Cover Your Butt: C3 supports federal legislation to cover colorectal cancer screening for uninsured  people before they reach Medicare eligibility.  HR 1738: The Colorectal Cancer Prevention, Early Detection, and Treatment Act will establish a program at the Centers for Disease Control and Prevention (CDC) to provide colorectal cancer screenings and treatment for low-income, uninsured and underinsured individuals who are not eligible for Medicare.

We also are working to pass laws to make sure that uncovered expenses don’t keep Medicare beneficiaries from taking part in screening. HR 1926/S 1164: The Colon Cancer Screen for Life Act will expand existing Medicare coverage of colorectal cancer screening to include pre-procedure visits and other reimbursements, minimizing the out-of-pocket expenses for our nation’s elderly.

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