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New study investigates colorectal cancer screening

A recent study from the UW School of Medicine and Public Health shows that people with insurance policies covering certain kinds of tests are more likely to be screened for colorectal cancer.

Researchers used electronic health records to examine rates of colorectal cancer screening rates for 33,177 under-65 patients who were due for screening. The researchers compared screening rates for those with and without policies that cover CT -- or computerized tomography -- colonography.

They found that individuals with that kind of policy were 48 percent more likely to be screened by any method compared to those without coverage that were due for screening.

“Our study suggests that when people are offered a greater choice of screening tests for colorectal cancer, including CT colonography, they are more likely to complete screening to prevent colorectal cancer,” said Maureen Smith, professor in the departments of population health sciences and family medicine, and lead for the study.

This type of scan is touted as less invasive than traditional colonoscopies, but Smith says only about two-thirds the number of people that should be screened ever end up getting checked.

“CT colonography is a newer technology that can detect both pre-cancer and cancer, but because it’s relatively new it isn’t widely covered by insurance and isn’t covered by Medicare,” Smith said.

Colorectal cancer kills over 50,000 people each year, according to the UW School of Medicine and Public Health. The American Cancer Society includes CT colonography in a list of screening tests for precancerous polyps and cancer in people age 50 or older.

In Wisconsin alone, 2,520 men and women were expected to be diagnosed with colorectal cancer in 2016 by the state Department of Health Services. DHS estimates about 67 percent of people survive five years or more after being diagnosed, and only 40 percent are diagnosed at an early age when the cancer is easier to treat.

But the numbers aren’t all bad: incidence rates and mortality rates for colorectal cancer were both on a steady decline in the state between 1995 and 2013, according to a recent report from DHS.

And the rate of Wisconsinites 50 years or older who have had a colonoscopy or sigmoidoscopy -- a method for examining the rectum and sigmoid, or lower colon -- was on the rise between 1997 and 2012, reaching nearly 80 per 100,000 in 2012.

Smith said the study’s findings hold particular relevance for policymakers, who “should consider additional options for screening and prevention of colorectal cancer” with groups in mind that traditionally have lower screening rates -- people in rural areas, racial/ethnic minorities and low-income individuals.

“Locally, insurers have been open to including CT colonography in their coverage,” Smith added. “Nationally, any change will probably rely on Medicare’s decision-making process, which can take substantially more time.”

--By Alex Moe


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