Colonoscopy for colorectal cancer screening
There are several procedures to screen for and detect colorectal cancer that affects the colon or rectum. “Regular screening can lead to the detection of polyps, and removing polyps prevents cancer,” says Foreman. Polyps are small growths that form on the lining of the colon. They are usually harmless, but after many years they can turn into cancer.
Colonoscopy is the gold standard test for colorectal cancer screening and can detect approximately 95% of colorectal cancer cases. It is also the only option that allows a gastroenterologist to simultaneously find and remove colon polyps. Although colonoscopy is a safe procedure, it has low risk of rupture and bleeding.
To check your colon during a colonoscopy, it must first be cleaned. “A lot of people are intimidated by bowel prep,” says Forman. “While it’s not perfect, it’s gotten easier. Some new bowel prep options require you to drink less and taste a little better. Pills are also available, but they may not be as safe depending on your age and other medical conditions,” he says.
Colonoscopy is usually performed under sedation. During this time, the gastroenterologist will insert a colonoscope (a flexible tube with a camera at the end) into the rectum and examine the entire colon for polyps. If nothing is found and the colon is properly cleaned, it is recommended to schedule the next colonoscopy in 10 years.
Other screening tests for colorectal cancer
Less invasive and/or less labor-intensive colorectal cancer screening options are available, but they are not as successful at detecting colorectal cancer as colonoscopy.
These include stool occult blood testing and multipurpose stool DNA tests, which examine stool samples for signs of colorectal cancer, and flexible sigmoidoscopy, which examines only part of the colon. If any of these tests show a positive result for colorectal cancer, a repeat colonoscopy is usually necessary.
Medicare coverage of colonoscopies and other colorectal cancer screening tests
Colonoscopy
If you are at high risk for colorectal cancer, Medicare covers a screening colonoscopy once a year. 24 months. High risk factors include a family history of the disease, colorectal cancer or colorectal polyps or inflammatory bowel disease. For those who are not at high risk, Medicare covers the test once a year. 120 months (10 years)or 48 months (four years) after a previous flexible sigmoidoscopy.
sigmoidoscopy
A flexible sigmoidoscopy This is a less invasive test than a colonoscopy, which looks at only the lower part of the colon. It is covered every 48 months (four years) if you are 50 years or older and at high risk, or once every 10 years after a colonoscopy if you are 50 years or older and not at high risk.
Stool tests
Fecal occult blood test covered every 12 months if you are 50 years or older and Medicare covers multipurpose stool DNA tests once every three years if you are between 50 and 85 years old, have no symptoms of colorectal disease, and are not at high risk of developing colorectal cancer. If you take any of these stool screening tests and get a positive result, Medicare will also pay for a follow-up colonoscopy.
Cost of colonoscopy and other colorectal cancer screening tests
Medicare and Medicare Advantage plans cover 100% of costs these procedures.
However, if your doctor finds and removes a polyp or other tissue during a colonoscopy, you are responsible for it. 15% of the Medicare approved amount. for your doctor’s services. If the procedure is performed at a hospital outpatient facility or ambulatory surgery center, you will also pay 15% of the facility’s coinsurance.
Medicaid coverage for colorectal cancer screening is available in all states, but each state offers different types of coverage.
Medicare coverage and cost of diagnostic colonoscopy
In addition to screening, colonoscopy can be used as a diagnostic tool for things like colorectal cancer symptoms, blood in the stool, weight loss, and changes in bowel habits.
During a diagnostic colonoscopy, your doctor may take a biopsy or remove polyps.
Diagnostic colonoscopy is usually performed 80% covered on Medicare after the deductible has been met. Some Medicare Advantage policies provide less expensive diagnostic colonoscopy coverage than traditional Medicare.
If you are planning to have a colonoscopy or colorectal cancer screening, don’t delay.
“It cannot be emphasized enough: most cases of colorectal cancer can be prevented with regular screening, and screening can save your life,” says Foreman.