Sunday, December 10, 2017
Health

The colonoscopy is a valuable test that should be affordable to all

Here's a health headline from earlier this week that's such a big deal that it bears repeating:

Colon cancer rates among Americans 50 and older fell 30 percent between 2000 and 2010, the American Cancer Society announced on Monday. New cases are down. So are deaths, as you can see in the accompanying chart.

This is huge. Colon cancer is the third leading cause of cancer death in the United States, but if trends continue, it could be far less of a threat in the near future.

What's going on?

One word: colonoscopies.

Unlike mammograms and PSA tests, colonoscopies not only detect cancer, they actually prevent it by allowing doctors to remove polyps before they become cancer. More than half of adults age 50 to 75 have had one, compared with just 19 percent in 2000, and it's paying off.

So getting a colonoscopy at recommended intervals should be a no-brainer, right?

Not if you don't have good insurance. The test, in which the doctor runs a scope through the colon of an anesthetized patient, can cost thousands of dollars.

It's little wonder that the greatest increase in colonoscopy use is among people 65 and older who have Medicare.

Anyone who has had a colonoscopy can confirm that preparing for the test is not the most pleasant experience imaginable. But researchers say the cost, not the prep, is the biggest reason people skip the test.

That situation has improved somewhat under the Affordable Care Act, which requires insurance policies that began after September 2010 to cover preventive screening colonoscopies with no out-of-pocket costs.

A less-invasive, lower-cost option is an annual stool test, which can flag the possible presence of cancer, though a positive finding must be confirmed through a colonoscopy. But for people who prefer a less-invasive test for personal or financial reasons, they're a fine choice, endorsed by experts around the world. There also was news this week of a new stool test on the way that's even better than existing tests at finding cancer.

Still, even stool tests may not be possible if you have no insurance, because they must be professionally interpreted. In Florida, 800,000 residents are too poor to buy insurance, yet can't qualify for a stingy Medicaid program that the governor and Legislature won't consider expanding.

Colon cancer isn't something that can wait until you hit Medicare age. In fact, the rate of colon cancers, though declining in the over-50 set, is slightly increasing for younger adults.

This week's news about colorectal cancer is wonderful for those fortunate enough to have access to screening. But too many Americans still face the possibility of a miserable fate made all the worse by the fact that it should be preventable.

Charlotte Sutton can be reached at [email protected] or (727) 893-8425.

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