|
E-mail this page to a friend!
Medicare News
More Senior Citizens Diagnosed at Earlier Stage of
Colon Cancer Due to Medicare Screening Coverage
About 60,000 cases of
colorectal cancer annually among senior citizens
December 20, 2006 Although it makes logical
sense, it is good to have hard evidence that since Medicare raised the
amount it will reimburse for colon cancer screening in 1998, there has
been an increase in use of colonoscopies by Medicare beneficiaries, and
a rise in the proportion of patients being diagnosed with colon cancer
at an early stage, when it is most treatable.
| |
Related Stories |
|
| |
Medicare Making Changes, Expanding Preventive Care
Services to Fight Diabetes
Expanding access in
rural areas, encouraging physician discussion
December 4, 2006 Medicare has announced expanded
preventive services and other changes beginning January 1, that will
affect millions of senior citizens battling diabetes. Diabetes screening
was first added to preventive services in 2005, but the agency says it
is making additions and changes that can help seniors with the disease
or even those at risk of diabetes. Below are the highlights.
Read more...
Medicare Announces Preventive Services Available for
Senior Citizens in 2007
November 2, 2006 Medicare has released the list
of preventive services that will be offered in 2007 to senior citizens
enrolled in Medicare Part B. There is at least one
addition to the "Welcome to Medicare" initial exam -
in 2007, people who are at risk for
abdominal aortic aneurysms may get a referral for a one-time screening
ultrasound. Read
more...
Read the latest news
on
Medicare
or
Medicare Drug Program |
|
The study in today's issue of JAMA points out that
although regular screening is the most effective way to detect colon
cancer at an early, curable stage, widespread screening has previously
been below optimal levels.
The 2000 National Health Interview Survey found
that 42.5 percent of respondents 50 years of age and older were up to
date with colon cancer screening with any of the recommended methods.
Among persons 65 years of age and older, 48.7 percent were up to date.
Several studies have suggested that lack of
insurance coverage may be one of the most important barriers to colon
cancer screening. Prior to 1998, Medicare did not routinely reimburse
for colon cancer screening.
Cary P. Gross, M.D., and colleagues from the Yale
University School of Medicine, New Haven, Conn., evaluated whether the
implementation of the expanded Medicare reimbursement policies after
1998 was associated with changes in the use of colonoscopy among
Medicare beneficiaries without cancer, as well as changes in the
proportion of colon cancer patients who were diagnosed at an early
stage.
The researchers analyzed data from the Surveillance
Epidemiology and End Results (SEER) -Medicare linked database of
individuals who were 67 years of age and older and had a primary
diagnosis of colon cancer during 1992-2002, as well as a group of
Medicare beneficiaries who were not diagnosed with cancer.
Among the patients with cancer, stage was
classified as early (stage I) vs. all other (stages II-IV).
Time was categorized as period 1 (no screening
coverage, 1992-1997), period 2 (limited coverage, January 1998-June
2001), and period 3 (universal coverage, July 2001-December 2002).
The researchers found that among the sample of
Medicare beneficiaries who did not have cancer, there was an increase in
colonoscopy use during the study period. The average colonoscopy rate
per 100,000 beneficiaries per quarter tripled from period 1 to 2, and
went up 6.5 times, comparing period 1 to period 3.
The final sample of patients with colorectal cancer
consisted of 44,924 patients (average age, 77.4 years; 56 percent were
women and 8 percent were black).
Time period was significantly related to stage at
diagnosis. Approximately 22.5 percent of patients were diagnosed at an
early stage in period 1 (1992-1997) compared with 25.5 percent in period
2 and 26.3 percent in period 3.
In further analysis, patients diagnosed in periods
2 and 3 were significantly more likely to have early-stage illness than
patients diagnosed in period 1.
Our finding that new Medicare policies may have
facilitated early diagnosis is encouraging and supports the institution
and evaluation of other efforts to broaden the access to and use of
screening tests in the older population.
"Given that there are approximately 60,000 cases of
colorectal cancer diagnosed annually among patients 65 years of age and
older in the United States, even a 4 percent increase in the percentage
of patients whose cancer is diagnosed at an early stage can have a
substantial impact at the population level, the authors write.
Increasing the use of screening tests further has
the potential to diagnose many more beneficiaries at an early stage.
EDITORIAL: Medicare policy and colorectal cancer
screening will changing access change outcomes?
In an accompanying editorial, Arden M. Morris,
M.D., M.P.H., of the University of Michigan, Ann Arbor comments on the
study by Gross and colleagues.
The findings of Gross et al demonstrate that the
change in Medicare policy was effective: a target population received
screening at a higher rate and this resulted in an increase in the
detection of early stage and right-sided cancers.
"It remains to be seen if future screening will
continue to increase the rates of early identification of colorectal
cancer.
"Given the costs of universal screening, if rates
of colonoscopy continue to increase without additional benefit in
overall diagnosis of early stage disease, policy makers, health care
organizations, and physicians may have to devise a feasible rationing
plan for broader colon screening.
"While increasing access to care and improving
compliance with recommended care is an undeniable good, providing
screening colonoscopy to all is not realistic.
The onus is on physicians and other primary care
clinicians to capitalize on the momentum associated with screening
colonoscopy to encourage other effective but less expensive forms of
screening, such as fecal occult blood tests with sigmoidoscopy.
"Screening colonoscopy could be made more effective
by targeting subgroups with higher incidence and mortality from
colorectal cancer, and those at greatest risk of right-sided or proximal
neoplasms that would not be identified by sigmoidoscopy. Such a
strategy, while difficult, would provide the best opportunity to
judiciously maximize access to care without sacrificing outcomes, Dr.
Morris writes.
Editor's Note: Dr. Morris is supported by a
Mentored Research Scholar Grant from the American Cancer Society.
|
Nursing Home Abuse, Medical Malpractice? Contact a lawyer.
click here
|
|
Click to More Senior News on the
Front Page
Copyright: SeniorJournal.com |
