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New Data Reveals That Gaps in Coverage for Those With Private Insurance Are Major Barriers to Colorectal Cancer Screening

Colorectal Cancer Screening Legislation Report Card Ranks State Efforts: Finally, More "A's" than "F's"

WASHINGTON, March 6 /PRNewswire-USNewswire/ -- For the first time, more U.S. states have received A grades than failing marks for colorectal cancer screening laws, according to the 2009 Colorectal Cancer Legislation Report Card. Issued today by a coalition of 11 leading public health groups and medical professional societies, the report card was released along with new data from the American Cancer Society Cancer Action Network(SM) (ACS CAN) attributing increasing colorectal cancer screening rates in part to state laws requiring private insurers to cover screenings, and a new survey revealing that inadequate coverage of the costs for colon cancer tests is the largest barrier for people seeking screenings who have private insurance.

Colorectal cancer (also known as colon cancer) is the second most common cause of cancer-related death in the U.S. when you combine totals for men and women, with only 10 percent of people who are diagnosed with the most advanced stage of the disease surviving five years. Yet when detected at its earliest stage, colon cancer is among the most treatable of all cancers, with a 90 percent 5-year survival rate. Furthermore, the disease can even be prevented through the early identification and removal of pre-cancerous polyps. The report card, now in its sixth year, gives "A" grades to states whose laws require insurance coverage according to current and future screening guidelines, which is particularly significant this year as guidelines have recently been updated to include new technologies like virtual colonoscopy and stool DNA testing. This year, Colorado, Kentucky and Maine join the list of A states, while Pennsylvania has raised its grade to B, from F.

New Survey Documents the Insurance Hurdle

Consumer concern over insurance coverage is illustrated in a new survey conducted by Harris Interactive on behalf of ACS CAN and the Entertainment Industry Foundation's National Colorectal Cancer Research Alliance (EIF's NCCRA). The poll surveyed 1,502 American adults aged 18 and above, all of whom have private health insurance (either through an employer, a spouse's employer or private purchase), to gauge their understanding of the importance of colon cancer screenings, their screening history and the factors that might affect whether or not they get screened.

  • Ninety percent of those surveyed who were over the age of 50 (the age at which everyone at average risk for colorectal cancer should begin screening) recognized colon cancer as the second leading cause of cancer-related death among men and women combined and understood that colon cancer is largely preventable with appropriate screening.
  • Despite this high awareness, one-third (34%) of individuals 50-plus said they had not had a colonoscopy to check for any signs of colon cancer in the past 10 years. (Respondents were not asked about screening methods other than colonoscopy.)
  • The majority (53%) of survey respondents age 50 and older indicated that there were certain circumstances that would prevent them from getting a colonoscopy. Of those circumstances, paying for procedure costs not covered by insurance -- either all or a portion of the full cost of the procedure -- ranked at the top of the list, compared to the inconvenience and possible discomfort and of a colonoscopy, which ranked a distant third.
  • Of the respondents 50 and older who said they had a colonoscopy within the past 10 years, 44 percent had to pay out of pocket for at least part of the procedure costs.
  • However, 70 percent of all survey respondents, including two-in-three (62%) of those 50 and older, said that if they knew that their insurance covered all of their colonoscopy procedure costs, they would be somewhat to much more likely to get a colonoscopy at age 50, or earlier if their doctor recommended.

Analysis Shows an Increase in Screening and Early Detection

New analysis of colon cancer data from 1999 to the present conducted by ACS CAN, the advocacy affiliate of the American Cancer Society, reveals that the United States has seen a dramatic increase in colorectal cancer screening among the 50-64 year old population over the past decade. According to ACS CAN, the increase in screening rates can be partly attributed to the increase in the number of states that require insurers to cover the cost of colorectal cancer screening, which has grown from zero to 29 in the past 10 years.

"The evidence is clear -- improving access to testing boosts screening rates, reduces health care costs and saves lives," said Daniel E. Smith, president of ACS CAN. "The fact that nearly 46 million Americans have no health insurance at all is a huge problem. And many Americans who have private insurance are not getting tested because they cannot afford it. We need to continue efforts to pass colon cancer screening coverage laws in states that don't have them so that more Americans age 50 and over can get the lifesaving screenings they need. "

One Patient, Two States

The need for comprehensive colon cancer screening legislation in all 50 states is underscored by the story of Catherine Murray-Rust: an academic librarian turned administrator and currently the Dean of the Library at Georgia Tech. Always active and health-minded, Catherine has completed two marathons, and today wears her training clothes to her chemotherapy sessions as a symbolic gesture of the new "marathon" in her life.

In 2003, Catherine moved to Colorado, an F state until just this year. She was in her mid-50s in 2006 when her doctor recommended a colonoscopy as part of her annual physical. Because it was classified as a preventative procedure by her insurer, and she had already used most of her $750 preventative care allotment that year, Catherine was responsible for the entire $3,000 procedure cost.

"I've always had every single test my doctor recommended," she explains. "From mammograms to Pap smears and now bone scans. I knew that I should have a colonoscopy, but the financial burden at that point was just too high."

Three years later, Catherine moved to Georgia, an A state since 2002. She was shocked to discover that because she was over age 50, she didn't even need a physician's referral for a colonoscopy to be scheduled, and with the cost completely covered by her insurer.

The results of her colonoscopy were shocking as well. The test revealed that Catherine had Stage 3 colon cancer, which she later found had spread to two of her lymph nodes. According to her oncologist, a colonoscopy in 2005 may have found her polyps early enough to prevent her cancer, and at the very least, would have caught it at a much earlier stage. She's now at the beginning of a 24 week course of intense chemotherapy.

"I always considered myself a healthy person," Catherine explains. "Unless people feel vulnerable, I don't think they're inclined to act on things like screening. And if they have to pay anything for preventive care, the barriers can be just too high."

About the Report Card Coalition

Launched in 2004, the Colorectal Cancer Legislation Report Card initiative is supported by a coalition that includes ACS CAN, American College of Gastroenterology, American Gastroenterological Association, American Society of Colon and Rectal Surgeons, American Society for Gastrointestinal Endoscopy, C3: Colorectal Cancer Coalition, Colon Cancer Alliance, Hadassah, Prevent Cancer Foundation, The Colon Club, The Jay Monahan Center for Gastrointestinal Health, and the Entertainment Industry Foundation's National Colorectal Cancer Research Alliance (EIF's NCCRA).

Now entering its sixth year, the Colorectal Cancer Legislation Report Card initiative continues to make an impact -- galvanizing the most influential organizations in the fight against colon cancer in order to generate crucial awareness of the importance of screening, and to affect the legislative landscape in a long list of states. The Report Card has become an important tool used by advocates at the state level in the effort to enact legislation requiring insurers to cover colon screening. When the Report Card Initiative began in 2004, 18 states had passed screening legislation. As of 2009, 29 states and the District of Columbia have passed legislation.

"We are thrilled to have more A states than F states for the first time ever," said Lisa Paulsen, CEO of the Entertainment Industry Foundation. "But, as our new survey data reinforces, there are still gaps in insurance coverage for colon cancer screening in a number of states that can have serious consequences. And that's true even for people with private health insurance. This is a tremendously important part of moving colorectal cancer off the list of major cancer killers."

Harris Interactive Survey Methodology

Harris Interactive(R) fielded the study on behalf of EIF from January 30 - February 3, 2009 via its QuickQuery(SM) online omnibus service, interviewing a nationwide sample of 2,241 U.S. adults aged 18 years and older, of which 1,502 had private health insurance, and 538 were aged 50 and older and had private health insurance. Data were weighted using propensity score weighting to be representative of the total U.S. adult population on the basis of region, age within gender, education, household income, race/ethnicity, and propensity to be online. No estimates of theoretical sampling error can be calculated; a full methodology is available.

SOURCE Entertainment Industry Foundation
Copyright©2009 PR Newswire.
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