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    More Colonoscopy, More Early Detection

    After Medicare Started Paying, More Got Colonoscopy and More Early Cancers Found
    WebMD Health News
    Reviewed by Louise Chang, MD

    Dec. 19, 2006 -- Colonoscopy is catching on, improving patients' odds of detection earlier, when coloncancer is usually more treatable.

    That news comes from researchers at Yale University's medical school, including Cary Gross, MD.

    They found a rise in colonoscopy screening and earlier colon cancer detection in people after Medicarestarted covering the procedure.

    In colonoscopy, doctors guide a thin, flexible tube with a tiny camera through the patient's colon to check for abnormalities, including cancer and precancerous growths.

    Colorectal cancer is the third most common cancer among U.S. men and women (not counting skin cancer), according to the National Cancer Institute.

    With about 60,000 new cases of colon cancer every year among those 65 and older, even a 4% rise in early diagnosis can have an impact, Gross' team notes.

    More Colonoscopies

    The new study, published in The Journal of the American Medical Association, is a snapshot of colonoscopy use in Medicare patients.

    Medicare didn't cover colonoscopy from 1992 to 1997. From 1998 to 2001, Medicare offered limited coverage, expanding to universal coverage in 2001.

    Gross' team studied data from all three periods.

    More Medicare patients got a colonoscopy after coverage became available, the study shows. That is, the Medicare colonoscopy rate was higher from 1998 to 2001 than from 1992 to 1997.

    But the colonoscopy rate didn't change when Medicare expanded its limited colonoscopy coverage to universal coverage.

    Earlier Diagnosis

    The researchers also analyzed the Medicare records of nearly 45,000 people aged 67 and older diagnosed with colon cancer from 1992 to 2002.

    They found that earlier detection became more common after Medicare covered colonoscopy.

    For instance, when Medicare didn't cover the procedure, the proportion of patients diagnosed at an early stage was 22.5%.

    That figure rose to 25.5% when Medicare offered limited colonoscopy coverage and increased to 26.3% when it provided universal coverage, the study shows.

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