Medicare for Colonoscopy

From: Poutinen, Jay (
Wed Aug 15 13:16:17 2001

MCW HealthLink Medical College of Wisconsin Milwaukee, Wisconsin

Colonoscopy Could Save Thousands of Lives Annually ----------------------------------------------------------------------

The use of colonoscopy to identify colon cancer should increase ---------------------------------------------------------------------- due to new Medicare coverage effective July 1, 2001, according to ---------------------------------------------------------------------- Sandra S. Green, MD, Associate Professor of Internal Medicine at the Medical College of Wisconsin. Medicare will now cover a colonoscopy every 10 years for members who are not at high risk for colorectal cancer. Medicare already covers colonoscopies every two years for high-risk beneficiaries. According to the Centers for Disease Control and Prevention (CDC), at least a third of the 57,000 deaths annually due to colorectal cancer could be prevented if people 50 years and older were screened regularly.

Colonoscopy is one of four colorectal screening tests covered by Medicare. Colonoscopy involves inserting a thin, flexible tube into the rectum and passing it up through the entire colon (large bowel), while the patient is under mild anesthesia. A tiny camera allows the physician to look for small growths (polyps) that can become cancerous if not removed. During a colonoscopy, the physician can remove or biopsy polyps. A typical colonoscopy takes 15-30 minutes and can be performed in a hospital outpatient department, clinic or doctor's office.

Regular screening for colorectal cancer should begin at age 50 for typical individuals. Colorectal screening should begin earlier and be conducted more often if there are increased risk factors, such as a family history of colorectal cancer or polyps. Colonoscopy is the most thorough screening method, though it is not without risk, suchas gastrointestinal bleeding or even perforation of the colon. It also requires anesthesia and preparation to cleanse the bowel, which can deter patients. Flexible sigmoidoscopy is a similar, but less comprehensive procedure. Two recent studies showed that half of the cases of advanced polyps found by colonoscopy in the right colon would have been missed by flexible sigmoidoscopy. The other major screening methods for colorectal cancer are fecal occult blood tests and barium enemas.

Some patients are embarrassed about colorectal cancer screening or concerned about discomfort associated with the procedures, but screening has been shown to save lives.


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