Gastroenterologists applaud President's call for screening tests coverage

Sep 11 2009

Gastrointestinal specialists from the American College of Gastroenterology applaud President Obama's call to cover preventive screening tests, such as breast cancer exams and colonoscopy. In his health care speech to a joint session of Congress last night, the President argued that "there's no reason we shouldn't be catching diseases like breast cancer and colon cancer before they get worse. That makes sense."

The American College of Gastroenterology has long supported the lifesaving potential of screening by colonoscopy specifically because it can detect and remove pre-cancerous polyps and thereby prevent the development of colorectal cancer.

"We know screening for colorectal cancer is good health policy, and makes good economic sense," commented ACG President Dr. Eamonn Quigley. Studies have shown that for every dollar spent by Medicare for this life-saving test cuts about $3 in long-term medical costs. The New England Journal of Medicine says that a colonoscopy colorectal cancer screening is one of the few preventive services shown to reduce future health care costs.

"That's a good return on investment in any business - especially when you're saving lives. When screening procedures detect colon cancer early, nine of ten patients beat the disease. In the absence of screening, colon cancer is usually found too late and many patients die. Those are starkly different outcomes that we have the power to change," added Dr. Quigley.

Colonoscopy is one of the most powerful preventive tools in clinical medicine because of its excellent sensitivity in detecting polyps and its potential for removing them and breaking the sequence of polyp to cancer in a single diagnostic and therapeutic intervention. The U.S. Preventive Services Task Force (USPSTF) provides its only Grade 'A' recommendation of cancer screening to colorectal cancer screens.

Yet colorectal cancer screenings remain underutilized as only 40 percent of colorectal cancers are diagnosed at an early stage, according to the latest figures released by the American Cancer Society. The Institute of Medicine cites poor provider reimbursement as one of the reasons for this underutilization as well.

"The American College of Gastroenterology continues to be deeply concerned that the lifesaving potential of colorectal screening tests is unrealized. The stark reality is that screening tests remain widely underutilized," commented Dr. Quigley.

At a time when the overall trend in colorectal cancer mortality is declining because of the use of screening tests, racial minorities, uninsured Americans, and Medicare patients who should be tested, are not being screened appropriately. Recent studies reveal that they are diagnosed with more advanced cancers compared to patients with private insurance. "We can point to impressive milestones indicating a trend moving in the right direction, yet much work remains. We will continue to champion the lifesaving potential of colonoscopy and work to expand access to lifesaving screening tests," said Quigley.

The American College of Gastroenterology is committed to national policy changes to improve access to colorectal screening and increased use of these proven prevention strategies, including reversing Medicare's massive cuts to reimbursement for these tests since the benefit was first introduced, as well as to payments in ambulatory surgery centers where many screening tests are performed. Congress is considering important colorectal screening legislation introduced by Senators Ben Cardin (D-MD) and Lindsey Graham (R-SC) as the "Supporting ColoRectal Examination and Education Now" or SCREEN Act (S. 1511). The bill will also be introduced in the House soon. The College supports this legislation, which aims to remove barriers to colon cancer screening for Medicare patients.