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Medicare News
Three of Four Senior Citizens Refuse Medicare’s Free
Colorectal Cancer Screening
American Cancer Society estimates over 147,000 new
cases and 57,000 deaths this year
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about colorectal cancer and testing below article. |
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Dec. 10, 2007 - A stunning three out of four senior citizens are
failing to take advantage of the Medicare funded screening for
colorectal cancer. It is stunning because regular colorectal cancer
screening can, in many cases, prevent colorectal cancer altogether,
according to the study published in the January 15 issue of CANCER, a
peer-reviewed journal of the American Cancer Society.
Screening for colorectal cancer, the third leading
cause of cancer death in both men and women, is currently recommended
for adults aged 50 and older.
The American Cancer Society estimates that in 2007,
more than 147,000 new cases will be diagnosed and more than 57,000
people will die from the disease.
The study examined a population-based sample of
153,469 cancer-free Medicare beneficiaries identified in 1998, the first
year in which colorectal cancer screening was reimbursed under Medicare.
The beneficiaries included 17,940 patients with one or more risk factors
for cancer and 135,529 “average risk” individuals.
Their analysis shows that between 1991 and 1997,
before colorectal cancer screening was reimbursed under Medicare,
screening was performed in 29.2 percent of the studied population.
This includes 76.7 percent of the increased risk
group, but only 22.9 percent of “average risk” patients.
In the years between 1998 and 2004, after screening
was covered by Medicare, only about one in four beneficiaries (25.4
percent) received guideline-based follow-up screening.
Screening was more commonly performed in younger
individuals, in Caucasians, in men, and in residents of areas with
higher income and educational level.
They also found that compared to those who were
never screened, patients who were screened between 1991 and 1997 were
significantly more likely to receive subsequent screening between 1998
and 2004.
The investigators note that the low overall
screening rates are consistent with previous studies, and that a
majority of Medicare beneficiaries received incomplete or no colorectal
cancer screening.
“Given the ability of screening tests to reduce
cancer incidence and mortality, continued efforts to promote screening
are clearly warranted,” they conclude.
The study was led by Gregory Cooper, MD, interim
chief of gastroenterology at University Hospitals Case Medical Center,
and Professor of Medicine at Case Western Reserve University (CWRU) and
the Case Comprehensive Cancer Center in Cleveland, Ohio, and Tzuyung
Doug Kou, also of CWRU.
Editor’s Notes:
Article: “Underuse of Colorectal Cancer Screening
in a Cohort of Medicare Beneficiaries.” Gregory S. Cooper and Tzuyung
Doug Kou, CANCER; Published Online: December 10, 2007 (DOI:
10.1002/cncr.23176); Print Issue Date: January 15, 2008.
About Colorectal Cancer and Screening Methods
Colorectal cancer is a disease in which cells in
the colon or rectum become abnormal and divide without normal control or
order, forming a mass called a tumor. (The colon and rectum are parts of
the body’s digestive system that remove water and nutrients from food
and store solid waste until it passes out of the body.) Cancer cells
invade and destroy the tissue around them. They can also break away from
the tumor and spread to form new tumors in other parts of the body.
Colorectal cancer is more likely to occur as people
get older. Although the disease can occur at any age, most people who
develop colorectal cancer are over the age of 50.
Colorectal cancer is the third most common type of
non-skin cancer in men (after prostate cancer and lung cancer) and in
women (after breast cancer and lung cancer).
It is the second leading cause of cancer death in
the United States after lung cancer. The rate of new cases and deaths
resulting from this disease is decreasing. Still, over 147,000 new cases
are diagnosed, and more than 57,000 people die from colorectal cancer
each year.
The exact causes of colorectal cancer are not
known. However, studies show that certain factors, such as age, are
linked to an increased chance of developing colorectal cancer:
Methods are used to screen
people for colorectal cancer?
Health care providers may suggest one or more of
the tests listed below for colorectal cancer screening.
● A fecal occult blood test (FOBT) checks
for hidden blood in the stool. Studies have proven that this test, when
performed every 1 to 2 years in people ages 50 to 80, reduces the number
of deaths due to colorectal cancer by as much as 30 percent.
● A sigmoidoscopy is an examination of
the rectum and lower colon using a lighted instrument called a
sigmoidoscope. Sigmoidoscopy can find precancerous or cancerous growths
in the rectum and lower colon. Studies suggest that regular screening
with sigmoidoscopy after age 50 can reduce the number of deaths from
colorectal cancer.
● A colonoscopy is an examination of the
rectum and entire colon using a lighted instrument called a colonoscope.
Colonoscopy can find precancerous or cancerous growths throughout the
colon, including the upper part of the colon, where they would be missed
by sigmoidoscopy. However, it is not known whether this benefit
outweighs the risks of colonoscopy, which include bleeding and
puncturing of the lining of the colon. More research is needed to
address these issues.
● A double contrast barium enema (DCBE)
is a series of x-rays of the entire colon and rectum. The x-rays are
taken after the patient is given an enema with a barium solution and air
is introduced into the colon. The barium and air help to outline the
colon and rectum on the x-rays. Research shows that DCBE may miss small
polyps.
● A digital rectal exam (DRE) is often
part of a routine physical examination. The health care provider inserts
a lubricated, gloved finger into the rectum to feel for abnormal areas.
DRE allows for examination of only the lower part of the rectum.
>>
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