Cancer screening costs exceed $40 billion annually in the United States

A modeling study suggests that cancer screening costs more than $40 billion annually in the United States. The estimate is based on available 2021 data for costs associated with screening for five common types of cancer. According to the researchers, this data is critical to help inform policy and priorities, including enhancing equitable access to recommended cancer screenings.

The findings are published in the journal Annals of Internal Medicine.

Researchers from the National Institutes of Health utilized national health care survey and cost resources data to estimate the annual cost of initial cancer screening (screening without follow-up costs) in the United States in 2021. To estimate the cost, the researchers multiplied the number of people screened for breast, cervical, colorectal, lung, and prostate cancer and associated healthcare system costs by the typical insurance cost per screen in 2021 dollars.

They found that cancer screening costs an estimated $43 billion annually, and colorectal cancer represented approximately 64% of the total cost. About 88.3% of costs were attributable to private insurance, 8.5% to Medicare, and 3.2% to Medicaid and other programs. Costs paid to screening facilities were a significant driver of the expense.

The authors emphasize that while this is a substantial total, recommended cancer screenings have been demonstrated to reduce cancer-specific mortality, and screening for breast, cervical, colorectal, and lung cancers has generally been reported to be cost-effective or cost-saving in the United States. Further, recommended cancer screenings increase detection of earlier-stage disease, which may result in decreased treatment costs, decreased financial hardship, and improved quality of life. 

An accompanying editorial says that estimating the cost associated with cancer screening is a useful start but may be an understatement because it does not consider three essential screening components that affect costs: subsequent testing, screening of ineligible patients, and overdiagnosis and overtreatment.

In addition, the editorialists note that the current study estimated the cost of screening only for the population defined as eligible by the U.S. Preventive Services Task Force. Yet, data suggests that screening ineligible patients is widespread, especially among older adults.

According to the editorialists, the substantial resources devoted to screening may be better directed toward ensuring widespread access to effective cancer treatment and addressing the social determinants of cancer risk.