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GAO: Most Plans Cover Colorectal Cancer Screening

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Even in states without colorectal cancer screening coverage requirements, most private health insurers provide coverage for colorectal screening tests.[@@]

The U.S. General Accountability Office has published figures supporting that conclusion in a report on an informal study of colorectal screening coverage practices.

Kathryn Allen, a GAO health care director, notes in the report that colon cancer and rectal cancer will kill almost 57,000 U.S. residents this year.

Doctors say most people over age 50 should receive regular colorectal screening procedures, but fewer than half of U.S. residents in that age group who were surveyed in 2002 said they had ever received any colorectal cancer screening services, Allen writes in her report.

Doctors use 4 popular screening tests, ranging from inexpensive scans for fecal blood to high-tech colonic inspections that can cost thousands of dollars.

GAO researchers found that 20 states require private health insurers to cover colorectal screening procedures.

In states without official screening requirements, all of the 19 small group plans reviewed covered some colorectal cancer screening procedures, and 17 were willing to pay for more than a basic fecal blood test.

The researchers also found that 4 of the 14 individual plans reviewed refuse to pay for any colorectal screening procedures but that the other 10 plans pay for all 4 of the popular cancer screening procedures.

Allen agrees with comments by America’s Health Insurance Plans, Washington, that U.S. residents’ low screening rates may be due partly to factors other than lack of coverage for screening procedures.

“Reasons that individuals do not obtain a colorectal cancer screening may include a lack of patient education, a general reluctance to be tested, or a physician’s lack of time to discuss or educate patients about screening,” Allen writes.

A copy of the GAO study is on the Web at //


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