If you exclude skin cancers, colorectal cancer is the third most common cancer in the United States. It’s also the third leading cause of cancer-related deaths (and second when you combine the numbers for both men and women). The fact that most people aren’t aware of either of those statistics is why President Clinton dedicated March as National Colorectal Cancer Awareness Month back in 2000.
The American Cancer Society estimates the year 2018 will bring around 140,250 new colorectal cancer cases. Survival rates improve dramatically with early detection. Regular screenings for everyone aged 50 or older could help prevent around 60 percent of colorectal cancer deaths.
In honor of Colorectal Cancer Awareness Month, we’re looking at the risk factors, steps you can take to lower your risk, and which preventive screenings Medicare covers.
Colorectal Cancer Risk Factors
When it comes to cancer, there are two types of risk factors: those you can change and those you cannot change.
Risk factors you can change
- Being overweight or obese
- Lower your risk by losing weight
- Being a heavy drinker
- Lower your risk by limiting yourself to two drinks per day (men) or one drink per day (women)
- Not being physically active
- Lower your risk by being more active
- Lower your risk by quitting smoking
- Following a diet high in red meats and processed meats
- Lower your risk by eating a plant-based diet
Risk factors you cannot change
Unfortunately, there are no lifestyle changes you can make to reduce these risk factors. They include:
- Age: Colorectal cancer is most common in people aged 50 or older
- Have a personal or family history of adenomatous polyps, particularly if they are large (1 cm or more) or show dysplasia
- Have a personal or family history of colorectal cancer
- Have a personal history of inflammatory bowel disease, including Crohn’s disease and ulcerative colitis
- Have an inherited syndrome such as familial adenomatous polyposis (FAP) or Lynch syndrome
- Have type 2 diabetes
- Are African American
- Are Jewish of Eastern European descent
Does Early Detection Improve Colorectal Cancer Survival Rates?
When it comes to fighting cancer, preventive screenings and early detection are the most powerful weapons in your arsenal. When colorectal cancer is found in an early stage, before it has a chance to spread, the survival rate is 90 percent. Unfortunately, only around 40 percent of cancers are found this early.
Polyps may take up to 15 years before they become cancerous. With regular screenings, they can be found and removed before they become cancerous.
What Colorectal Cancer Screenings Are Covered by Medicare?
Medicare covers a variety of preventive services, including numerous colorectal cancer screenings designed to detect the disease early. If you are age 50 or over, or are at high risk for colorectal cancer, Medicare covers at least one of the following tests.
Barium enema screening
Medicare Part B covers this test once every 48 months for patients aged 50 or older OR once every 24 months for those who are considered high risk for colorectal cancer.
If you are at high risk for colorectal cancer, Medicare covers this screening every 24 months. If you are not considered high risk, Medicare covers colonoscopy screenings once every 120 months OR 48 months after a flexible sigmoidoscopy.
If your qualified health provider accepts assignment, you pay nothing for the colonoscopy. However, if the colonoscopy is considered diagnostic, you may pay 20 percent of the Medicare-approved amount as well as a deductible if the test occurs in a hospital setting. A colonoscopy crosses from screening to diagnostic if it results in the removal or biopsy of a growth or lesion, or if the removal or biopsy occurs during the same visit as the colonoscopy.
Fecal occult blood test
Medicare covers this screening once every 12 months for patients who are aged 50 or older. There is no out-of-pocket cost for this test if you have a referral from your doctor, physician assistant, nurse practitioner, or clinical nurse specialist.
Multi-target stool DNA test
This is an at-home screening that Medicare covers once every three years at no cost to you, assuming you meet all of the following conditions:
- You are between 50 and 85 years of age
- You are at average risk for developing colorectal cancer
- You show no signs or symptoms of colorectal disease
Flexible sigmoidoscopy screening
Coverage for this test is once every 48 months for most people aged 50 or older. If you had a previous colonoscopy screening, Medicare covers this test after 120 months (assuming you are not at high risk).
If your qualified health provider accepts assignment, you pay nothing for this screening. However, if the test becomes a diagnostic flexible sigmoidoscopy, you may pay 20 percent of the Medicare-approved amount and a copay if the test occurs in a hospital setting.
How Much Do Colorectal Cancer Screenings Cost?
Assuming you meet the criteria, Medicare Part B covers all of the above screenings. However, the cost to you varies. If you have Medicare Supplement Insurance (Medigap), this may help cover some of your copayment and deductible costs. Talk to your provider to be sure.
Variables that affect your cost include:
- The amount your healthcare provider charges
- The type of facility the screening occurs in
- Whether you have other coverage
- Whether your healthcare provider accepts assignment
If your healthcare provider suggests testing for colon cancer, check your Medicare plan or Medigap policy for coverage. Also, talk to your doctor about whether they accept assignment and whether the amount they charge falls within Medicare’s guidelines.