In his speech before a joint session of Congress on September 9, 2009, President Obama called out colorectal cancer screening as saving both money and lives. To applause from listening members of Congress, he said:
And insurance companies will be required to cover, with no extra charge, routine checkups and preventive care, like mammograms and colonoscopies because there’s no reason we shouldn’t be catching diseases like breast cancer and colon cancer before they get worse. That makes sense, it saves money, and it saves lives.
We applaud the President’s public acknowledgment that colorectal cancer screening saves lives and money.
Screening saves lives by finding cancers early when they are most treatable. Screening also prevents colorectal cancer by finding and removing precancerous polyps, which keeps them from ever growing into cancer.
Colorectal cancer screening is cost-effective, as evidenced by multiple analyses (see below), which is one reason Medicare began to cover screening in the late 1990’s.
- Unlike preventive screenings like mammograms and pap tests, colorectal cancer screening is not always defined as “preventive care,” so deductibles and co-pays may apply. In other words, even people with insurance may have to pay up to their deductible or pay a part of the cost to get screened for colorectal cancer.
- People without insurance are much less likely to be screened … and with the skyrocketing cost of treatment, Medicare spending for treatment of colorectal cancer is increasing rapidly.
Thanks to hard work by C3 and advocates such as yourself, a national screening program for the un- and under-insured has been proposed in Congress:
Once passed, the program has the potential to save over 30,000 lives and $15 BILLION (through Medicare savings) every year. It will build on success of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). The NBCCEDP has provided over 8 million screenings since 1991. Think of the lives that will be saved once a national colorectal program is in place!
President Obama highlighted screening colonoscopies because they save lives and money. If you agree, you can urge your elected officials to take action.
More about screening and colonoscopies
Colorectal cancer screening saves lives. Even the simplest fecal occult blood testing can reduce deaths from colon and rectal cancer by 30 percent.
A colonoscopy examines the entire colon all the way to the cecum at its very beginning. If a polyp is found, it can be both biopsied and removed. If an early cancer is detected, it can be treated and cured.
Other screening methods search for hidden blood or changed DNA in the stool. If it is found, a follow-up colonoscopy searches for polyps or early cancers. CT colonography, or virtual colonoscopy, uses x-rays to take pictures of the interior of the colon and rectum. Again if polyps or cancers are uncovered, colonoscopy is used to remove polyps or biopsy potential early cancers.
Colonoscopy screenings also save money. A program in New York City that uses colonoscopy to screen low-income people without insurance found that if Medicare paid for colonoscopy screening for average risk individuals ages 50 to 64, it would save $2 in later treatment expense for every $1 that the screenings and early treatment cost.
Screening Legislation in the US Congress
Currently there are several bills in Congress designed to expand access to colorectal cancer screening, both for the uninsured and for those with insurance.
- HR 1189: Colorectal Cancer Prevention, Early Detection, and Treatment Act of 2009 would establish a national screening program at the Centers for Disease Control and Prevention and give states the option to provide medical assistance for men and women screened and found to have colorectal cancer or colorectal polyps.
- HR 1330: Colorectal Cancer Screening and Detection Coverage Act of 2009 would require that group health plans provide colorectal cancer screening for plan participants who were 50 and over or who were at high risk for colorectal cancer. Co-pays would be limited to 5 percent of the payment amount and would not be subject to deductible. In addition, “Nothing in this section shall be construed to require an individual who is a participant or beneficiary to undergo colorectal cancer screening.”
- S 717: 21st Century Cancer ALERT (Access to Life-Saving Early detection, Research and Treatment) Act includes a section on colorectal cancer screening that would provide grants to states and tribal organizations for colorectal cancer screening for people who lack adequate insurance to cover screening. It would also allow states the option of using Medicaid to cover colorectal cancer treatment cancer found during those screenings.
- S 1511: Supporting ColoRectal Examination and Education Now (SCREEN) Act of 2009 makes a number of changes in existing legislation that would encourage colorectal cancer screening, awareness, and education and reduce out-of-pocket costs.
Some Research Evidence for Screening Cost Effectiveness
- Pignone M, Rich M, Teutsch SM, Berg AO, Lohr KN. Screening for colorectal cancer in adults at average risk: a summary of the evidence for the U.S. Preventive Services Task Force. Annals of Internal Medicine 2002;137(2):132-41.
- Vijan S, Hwang EW, Hofer TP, Hayward RA. Which colon cancer screening test? A comparison of costs, effectiveness, and compliance. Am J Med 2001;111(8):593-601.
- Frazier AL, Colditz GA, Fuchs CS, Kuntz KM. Cost-effectiveness of screening for colorectal cancer in the general population. Journal of the American Medical Association, 2000;284(15):1954-61.