Congress passed legislation in December, amending a 1997 statute, which had provided the initial colorectal cancer screening mandates. Following are the Medicare guidelines under this new legislation:

Fecal Occult Blood Tests — will be reimbursable annually (when ordered by the patient's attending physician) for all patients Flexible Sigmoidoscopy — will be reimbursable once every four years for average-risk patients; Screening Colonoscopy — will be reimbursable once every ten years for average-risk patients; Screening Colonoscopy — will continue to be reimbursable once every two years for high-risk (see definition below) patients. The potential complications of colorectal cancer – a disease, which claims the lives of 56,000 annually, are minimized when individuals adhere to regular screenings. While these Medicare benefits reduce a financial barrier that may have prevented individuals from being screened, statistics show that very few people have taken advantage of previous Medicare reimbursements, according to the American College of Gastroenterology (ACG).

“With Medicare now providing reimbursement for colorectal screening tests, the economic impediment has been removed as a reason for many patients not to be screened,” said Dr. Philip Schoenfeld, ACG Member and Assistant Professor of Medicine, University of Michigan, School of Medicine. “But utilization of the new benefit is still embarrassingly low. The General Accounting Office issued a report in March 2000 indicating that only about 1 percent of Medicare beneficiaries are taking advantage of the colorectal cancer screening benefit. We still have a long way to go in educating the public.”

National Colorectal Cancer Awareness Month provides the opportunity for participating groups such as the College to reach the public through various outreach activities. Throughout March, ACG will be focusing its efforts on public education campaigns that stress the critical steps individuals can take to prevent this disease from devastating their lives. Consumers may call a toll-free consumer health line (800-978-7666) or log onto the ACG Web site at www.acg.gi.org, for more information on colorectal cancer.

No one likes to discuss colorectal cancer, but silence can be deadly. The College, along with the collaborating organizations, hope to begin breaking the taboos, and get people to their doctors to be screened. “With early detection, we can reduce the mortality rate of colorectal cancer, the number two cancer killer, by at least 80 percent,” said Dr. Schoenfeld.

ACG Screening Recommendations:

The Medicare average-risk benefit is important because, as stated in recent articles (i.e. June 15, 2000 and July 20, 2000 articles in New England Journal of Medicine), scientists recognize the colonoscopy as the best test for diagnosis of colorectal cancer. ACG’s own recommendations published in the April, 2000 issue of The American Journal of Gastroenterology state, “several lines of evidence suggest colonoscopy is the most effective colorectal cancer prevention test currently available.” The recommendations go on to cite colonoscopy every ten years as the preferred screening strategy.

Risk Factors:

Men and women can reduce their risk of developing colorectal cancer through healthy lifestyle choices and regular screenings after age 50. Women are just as likely as men to develop colorectal cancer. Although the chance of developing colon cancer increases after age of 40, the disease is most common after the age of 50. Colorectal cancer also can be diagnosed in much younger people. African Americans and Hispanics are at higher risk and are more likely to be diagnosed when the disease is at an advanced stage. Close relatives of a person who has had polyps or colorectal cancer before the age of 60 and people with one of several chronic digestive conditions have a higher than average risk of developing colorectal cancer. Individual at High Risk for Colorectal Cancer are Defined as an Individual with:

A sibling, parent or child with colorectal cancer or adenomatous polyposis A family history of familial polyposis A family history of hereditary non-polyposis colorectal cancer A personal history of adenomatous polyps A personal history of colorectal cancer, or Inflammatory bowel disease, including Crohn's Disease and ulcerative colitis ACG provides educational material to consumers through a toll-free number, 800-978-7666, and also through its Web site www.acg.gi.org.

ACG was formed in 1932 to advance the scientific study and medical treatment of disorders of the gastrointestinal tract. The College promotes the highest standards in medical education and is guided by its commitment to meeting the needs of clinical gastroenterology practitioners.