Vermont: Only state to pass bill mandating coverage of colon cancer screening

Many States Putting Critical Lifesaving Legislation on Hold While Waiting for Congress to Act on Health Care Reform

Progress towards nationwide, state-mandated coverage of colon cancer screening according to accepted medical guidelines has slowed to a crawl as state legislators await the outcome of the health care reform debate at the federal level, a coalition of public health associations and medical professional societies reported today.  With a better grade for only a single state – Vermont – 2009 marks the least improvement in a single year since the Colorectal Cancer Legislation Report Card began in 2004.  

Vermont improved from a "F" to an "A" by passing a bill to require insurance carriers to cover the full range of colorectal cancer screenings, with out-of-pocket costs capped at $100, as reported in the 2010 Colorectal Cancer Legislation Report Card, issued today by a coalition of leading public health groups and medical professional societies.

"The facts are pure and simple: in states with laws mandating coverage of colon cancer screening, more people get screened, and that – in turn – saves lives.  We cannot afford for the states without legislation to take a wait and see attitude," said John R. Seffrin, PhD, CEO, American Cancer Society Cancer Action Network (ACS CAN), the advocacy affiliate of the American Cancer Society.  "Gridlock in our nation's capital should not mean that citizens in states like Florida, Arizona and Ohio – and the 15 others with an "F" on the Report Card – can't get the cost of this potentially life-saving test covered."  

With the addition of Vermont, 22 states and the District of Columbia now require insurance coverage of colonoscopies and other procedures that follow accepted medical guidelines, earning them the grade of "A".  Ten other states require varying degrees of coverage, with scores of B, C or D, while 18 states score an "F" for failing to mandate any coverage of colon cancer screening.

"The national health care reform debate has caused uncertainty among policymakers, consumers, insurers and health care providers as to what the future might hold for tests like colon cancer screenings," said Seffrin.  "The only way to stop the gridlock is for Congress to act now and pass meaningful health care reform. At the same time, state lawmakers need to know that the bills pending in Congress should be seen only as a floor for coverage. We will continue to work with the states to implement the strongest laws possible that meet our guidelines for guaranteeing coverage of lifesaving preventive tests, such as colon cancer screenings."

Colorectal cancer (also known as colon cancer) is the second-most common cause of cancer-related death in the U.S. when totals for men and women are combined, with only 10 percent of people who are diagnosed with the most advanced stage of the disease surviving five years.  Yet when detected at its earliest stage, colon cancer is among the most treatable of all cancers, with a 90 percent 5-year survival rate.  Furthermore, the disease can often be prevented entirely through the early identification and removal of pre-cancerous polyps.

Guidelines recommend that both men and women at average risk should get screened starting at age 50, and that those with risk factors such as a family history of colorectal cancer should talk to their doctors about the possibility of starting screenings earlier.

Despite widespread awareness about the importance of colon cancer screenings, insurance coverage is still a barrier to screening according to a 2009 survey undertaken by Harris Interactive on behalf of ACS CAN and the Entertainment Industry Foundation's National Colorectal Cancer Research Alliance (EIF's NCCRA).  

Of the 53 percent of survey respondents age 50 and older who indicated that there were certain circumstances that would prevent them from getting a colonoscopy, paying for procedure costs not covered by insurance – either all or part of the cost – ranked at the top of that list.  

In fact, of the respondents 50 and older who said they had a colonoscopy within the past 10 years, 44 percent had to pay out of pocket for at least a portion of the procedure costs.  Still, 70 percent of all survey respondents, including two-in-three (62 percent) of those 50 and older, said that if they knew that their insurance covered the entire cost of colonoscopy, they would be somewhat to much more likely to have the procedure at age 50, or earlier if their doctor recommended.

"We are pleased to see that another state has taken its place on the 'A list'," said Lisa Paulsen, CEO of the Entertainment Industry Foundation, the 501(c)(3) non-profit organization of which the National Colorectal Cancer Research Alliance is a part, "but almost 50,000 Americans will die of colon cancer in 2010.  With appropriate screening, this disease is largely preventable and often curable when caught early.  Ensuring that the people who should be screened get screened is central to knocking colon cancer off the list of our leading cancer killers, and these state laws help facilitate that.  For only one state to have passed such legislation in the past year is just too little progress," Paulsen said.

SOURCE Report Card Coalition