By Holly Glen Gearhart
The treatment of colon cancer has improved to the point at which survival is nearly universal-if caught in its early stages. The “gold standard” to check for colon cancer is a colonoscopy, but with cost cuts on the horizon for Medicare and other managed care programs, there is a less costly test.
The most common test is the fecal occult blood test, which is readily available at most health clinics and doctors’ offices. The test does not, however, detect the presence of polyps which are potentially cancerous growths in the colon. Fecal blood tests are used, rather, to detect blood in the stool, often a first sign of cancer in the colon.
According to the American Cancer Society, a colonoscopy is the best way to inspect the colon for polyps or other abnormalities that may begin as non-cancerous, but which nearly always develop into cancerous growths.
Although far less expensive and less intrusive, the fecal occult blood test will detect occult (hidden, not obvious) blood in the stool. If blood is present your physician will make a decision if further testing is necessary.
Most health plans will cover the fecal blood test; its cost is much lower than a colonoscopy by a few hundred to a few thousand dollars. The fecal occult blood test can be done at your home and the sample is usually mailed to a facility that will test it for occult blood.
Colonoscopies require a specialist and cannot be performed at home, thereby incurring costs for a clinic or hospital visit, medical attendants and test results read and interpreted by medical specialists. If polyps are found during the colonoscopy they are removed and tested for cancer.
Full colon testing, as opposed to a simple fecal occult blood test, is like any other medical test and must be approved by a physician. The costs of either are currently covered by Medicare and Medicare Advantage plans. Not all Advantage plans cover the same test at the same rate, though; some cover 80 percent and some as much as 100 percent of the cost, and you need to check your personal coverage to avoid owing a great deal of money for the full colonoscopy.
For those with Medicare, the following applies:
- • You pay nothing for the fecal occult blood test, but you generally have to pay 20 percent of the Medicare-approved amount for the doctor’s visit. The Part B deductible doesn’t apply for the test.
- • You pay nothing for the flexible sigmoidoscopy or screening colonoscopy, if your doctor accepts assignment.
- • For barium enemas, you pay 20 percent of the Medicare-approved amount for the doctor’s services. In a hospital outpatient setting, you also pay a copayment. The Part B deductible doesn’t apply.
- • If a screening test results in the biopsy or removal of a lesion or growth during the same visit, the procedure is considered diagnostic and you may have to pay coinsurance or a co-payment, but the Part B deductible doesn’t apply.
According to the Mayo Clinic there are many lifestyle factors which may influence the occurrence of colon cancer including:
- • Older age. About 90 percent of people diagnosed with colon cancer are older than 50. Colon cancer can occur in younger people, but it occurs much less frequently.
- • African-American ethnicity. African-Americans have a greater risk of colon cancer than do people of other races.
- • A personal history of colorectal cancer or polyps. If you’ve already had colon cancer or adenomatous polyps, you have a greater risk of colon cancer in the future.
- • Inflammatory intestinal conditions. Chronic inflammatory diseases of the colon, such as ulcerative colitis and Crohn’s disease, can increase your risk of colon cancer.
- • Inherited syndromes that increase colon cancer risk. Genetic syndromes passed through generations of your family can increase your risk of colon cancer. These syndromes include familial adenomatous polyposis and hereditary nonpolyposis colorectal cancer, which is also known as Lynch syndrome.
- • Family history of colon cancer and colon polyps. You’re more likely to develop colon cancer if you have a parent, sibling or child with the disease. If more than one family member has colon cancer or rectal cancer, your risk is even greater. In some cases, this connection may not be hereditary or genetic. Instead, cancers within the same family may result from shared exposure to an environmental carcinogen or from diet or lifestyle factors.
- • Low-fiber, high-fat diet. Colon cancer and rectal cancer may be associated with a diet low in fiber and high in fat and calories. Research in this area has had mixed results. Some studies have found an increased risk of colon cancer in people who eat diets high in red meat.
- • A sedentary lifestyle. If you’re inactive, you’re more likely to develop colon cancer. Getting regular physical activity may reduce your risk of colon cancer.
- • Diabetes. People with diabetes and insulin resistance may have an increased risk of colon cancer.
- • Obesity. People who are obese have an increased risk of colon cancer and an increased risk of dying of colon cancer when compared with people considered normal weight.
- • Smoking. People who smoke cigarettes may have an increased risk of colon cancer.
- • Alcohol. Heavy use of alcohol may increase your risk of colon cancer.
- • Radiation therapy for cancer. Radiation therapy directed at the abdomen to treat previous cancers may increase the risk of colon cancer.
Your doctor is the best resource for ordering tests you may need; talk to your physician about when you should get tested and what kind of test is preferred for you.
For more information, please visit Medicare.gov or call 1 (800) 633-4227.