Medicare Reimbursements Boost Colon Cancer Screening, Detection
Medicare's decision to begin reimbursing for colon cancer screenings has led to an increase in colonoscopies and earlier detection of the disease, according to a study published Wednesday in the Journal of the American Medical Association, the Washington Times reports.
Medicare in 1998 began covering colonoscopies for people at risk for colon cancer based on family histories. In July 2001, Medicare expanded reimbursements to include anyone older than 50.
For the study, researchers looked at data on more than 44,000 Medicare patients diagnosed with colon cancer between 1992 and 2002 and at a group of Medicare beneficiaries who were not diagnosed with cancer.
The researchers found that the proportion of seniors with colon cancer that was diagnosed at an early stage increased from 22.5% during the five years before the first Medicare reimbursement change to 26.3% from July 2001 through December 2002.
Cary Gross of Yale University, who led the study, said, "The rate of colonoscopies tripled after the first change in Medicare coverage. After the second change, when colonoscopy coverage became universal for Medicare beneficiaries, the rate doubled again. So overall it went up sixfold, which is a huge increase." However, Gross added it is disappointing to detect "only ... one-fourth of cases at an early stage."
In an editorial accompanying the study, Arden Morris, an assistant professor of surgery at the University of Michigan, said the findings "demonstrate that the change in Medicare policy was effective."
However, Morris said it "remains to be seen if future screening will continue to increase the rates of early identification of colorectal cancer." Morris said that, because colonoscopies range in price from $800 to $2,000, it is "not at all realistic" for Medicare to provide universal coverage of colonoscopies and that she foresees the need for a "feasible rationing plan for broader colon screening" (Howard Price, Washington Times, 12/20).
An abstract of the study is available online.