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President Obama: Colonoscopies Save Money and Lives

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.

However:

  • 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

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4 Comments

  1. mary said:

    I am stage 4 colon cancer patient diagnosed 8/05. my question to all is… will the new health care plan treat with intent to prolong life or will the patient just be made comfortable since they are stage 4? If the later, I would never had the pleasure of meeting my latest grandchild! I do have insurance that we have paid into for the last 40 years (same company) and have had no other major health problems. I resent the fact that this may change. All I want is to see all 1100….pages of the bill and read it with my lawyer.

  2. Kate Murphy said:

    As we understand it, insurance would still continue to cover treatment for advanced cancer. No changes are contemplated that would not treat people with stage IV colorectal cancer.

    Right now there are at least three bills in the House and Senate. None include any provision for denying care to people whose cancer is advanced, nor would they change Medicare coverage of treatment for stage IV cancer.

    Before any final bill is passed in both houses of Congress and sent to the President, changes are possible. C3 and other cancer advocates would certainly oppose any changes in either insurance coverage or Medicare that denied care that would extend lives or improve quality of life for people with cancer.

    We suggest that you contact your member of Congress and Senators with your concerns.

    If you would like to read current legislation in the House of Representatives:

    HR 3200 America’s Affordable Health Choices Act of 2009 (Introduced in House)

  3. Annette Bates said:

    My daughter was diagnosed w/stage 3 colorectal cancer at only age 20,instead od studying in college she had to deal w/a deadly disease instead. Thanks for your time & help. Annette Bates

  4. Judy F said:

    Can we anticipate any changes to private and public insurance carriers coverage of screening colonoscopies in July 2012?

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