Bethesda, MD – Colorectal cancer (CRC) is the third leading cause of cancer death among men and women nationwide, yet only half of people who need CRC screening receive it. The American Gastroenterological Association (AGA) is working to educate patients about the importance of screening and to encourage everyone age 50 and older to get screened for CRC.
“The reduction in deaths from colorectal cancer in the U.S. since 1990 has been one of the great success stories in the cancer field,” according to Ian L. Taylor, MD, PhD, AGAF, president of the AGA Institute. “While the cause of this dramatic improvement is multi-factorial, effective screening and early detection has undoubtedly played a major role.”
There are a number of colorectal screening options, which vary by the extent of bowel preparation, as well as test performance, limitations, time interval and cost. The AGA considers colonoscopy the definitive test for CRC screening and prevention since it can detect cancer at an early, curable stage and prevent cancer by removing pre-cancerous polyps. Colonoscopy is a cost-effective way to save lives that, according to a New England Journal of Medicine article, reduces mortality at a cost savings to the health-care system.1 For detailed information on CRC screening options, please see the AGA brochure CRC Prevention and Treatment.
Increased Access is Needed for Colorectal Cancer Screenings
AGA believes that all individuals should have access to the colorectal cancer screening option that works best for them, as decided by the patient and their physician, and advocates that patients should have access to colonoscopies through Medicare and Medicaid and their private health insurance plans.
According to the Patient Protection and Affordable Care Act, in 2011, Medicare and Medicaid will no longer charge copayments for proven preventive screenings such as CRC screenings. Medicare will also waive the deductible for CRC screenings regardless if a polyp or lesion is found. However, the copayment is not waived when a screening colonoscopy becomes therapeutic and AGA has been aggressively lobbying to change this inequity.
Coverage of preventative care is limited to services that have an “A” or “B” rating from the U.S. Preventative Task Force. “A” recommendations for colon cancer screening include fecal occult blood testing (FOBT), sigmoidoscopy and colonoscopy. AGA is working to make sure that plans will not “steer” patients to FOBT because it is less costly and ensure that patients have an array of screening options.
“The AGA encourages the Department of Health and Human Services to adhere to professional society guidelines on colorectal cancer screening to ensure that insurers do not limit patient access to various screening modalities,” said Dr. Taylor. “Both public and private health insurers should be required to cover all recommended options for screening for everyone age 50 years and older, or 45 years and older for those at higher risk, with reasonable copayment.”
National Colorectal Cancer Awareness and Screening Day
Recognizing that those without insurance have limited access to screening, gastroenterologists and physicians throughout the country have established free CRC screening programs for the uninsured. On National Colorectal Cancer Awareness and Screening Day (March 25, 2010), programs in a number of states throughout the country are holding simultaneous screening events on March 25 and 26, 2011, to check patients for this deadly cancer and raise awareness of the importance of screening. AGA is preparing for a national screening program to occur in 25 states in 2012.
“The AGA Institute firmly believes that all Americans should have access to life-saving colorectal cancer screenings. If caught early, colorectal cancer is very treatable,” said Carla H. Ginsburg, MD, MPH, AGAF, who is coordinating the program for the AGA. “The AGA applauds the physicians who are donating their time to screen patients who wouldn’t otherwise be checked for colorectal cancer. We encourage all patients over age 50 to talk with their doctor about their colorectal cancer screening options.”
In addition to following recommended screening guidelines, people can reduce their risk of developing or dying from CRC through regular physical activity and maintaining a healthy body weight.
About Colorectal Cancer
According to the American Cancer Society, CRC is the third most common cancer diagnosed in men and women in the U.S. and is the third leading cause of cancer death for men and women. CRC is preventable, treatable and beatable. It can be prevented by finding and removing polyps before they become cancerous, and is highly treatable if found in its early stages.
An estimated 142,570 cases of CRC occurred in 2010. CRC is the third most common cancer in both men and women. CRC incidence rates have been decreasing for most of the past two decades from 66.3 cases per 100,000 population in 1985 to 45.5 in 2006. The decline accelerated from 1998 to 2006 (3 percent per year in men and 2.2 percent per year in women), in part because of increases in screening that allow the detection and removal of colorectal polyps before they progress to cancer.
Approximately 51,370 deaths from CRC were expected to occur in 2010, accounting for almost 9 percent of all cancer deaths. Mortality rates for CRC have declined in both men and women over the past two decades, with a steeper decline since 2002 (3.0 percent per year from 2002 to 2005 in both men and women, compared to 3.4 percent per year from 1990 to 2002 in men and 1.8 percent per year from 1984 to 2002 in women). This decrease reflects declining incidence rates and improvements in early detection and treatment.
About the AGA Institute
The American Gastroenterological Association is the trusted voice of the GI community. Founded in 1897, the AGA has grown to include 17,000 members from around the globe who are involved in all aspects of the science, practice and advancement of gastroenterology. The AGA Institute administers the practice, research and educational programs of the organization. www.gastro.org.
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Cohen et al. Does Preventive Care Save Money? Health Economics and Presidential Candidates. NEJM 2008; 358: 661-3.