A: Beginning at
age 50  everyone
should start colon
cancer screening.

A colonoscopy at
age 50 and every
10 years is
recommended.
Push for law on colon test insurance
BY DELTHIA RICKS

March 21, 2007

A coalition of doctors and advocates has given New York a grade of "F" for not
having a law on the books requiring health insurance companies to cover
colon screenings in efforts to prevent colorectal cancer.

But the insurance industry has responded by saying a law is not necessary
and that major insurers have been covering the cost of a colonoscopy - about
$650 - for years.

The group of medical professionals calling itself The Report Card Coalition,
which includes the American College of Gastroenterology, the Colorectal
Cancer Coalition, the American Society of Colon and Rectal Surgeons, the
American Society for Gastrointestinal Endoscopy and the American Cancer
Society, say they want laws in states that lack them. The federal government,
coalition members say, passed such a law in 2000 that allows Medicare to
cover colonoscopies.


Colorectal Cancer Screening

Screening, or testing, is done while you are feeling well -- to find any
abnormalities early, before signs and symptoms of disease occur. Screening
for colorectal cancer allows for the early detection of cancer when it is highly
curable, as well as the detection of growths (polyps) that might eventually
become cancer. These polyps may be removed, preventing the development
of cancer altogether.


Colorectal Polyps

There are several tests used to screen for colorectal cancer and polyps:

  • Fecal occult blood test: The fecal occult blood test (FOBT) is used to
    find occult (hidden) blood in feces. Blood vessels at the surface of
    colorectal polyps or cancers are often fragile and easily damaged by the
    passage of feces. The damaged vessels usually release a small amount
    of blood into the feces. Only rarely is there enough bleeding to color the
    stool red. The FOBT detects blood through a chemical reaction.

The traditional version of this test cannot tell whether blood is from the colon
or from other portions of the digestive tract (i.e., the stomach). Therefore, if
this test is positive, a colonoscopy is needed to see if there is a cancer, polyp,
or other cause of bleeding such as ulcers, hemorrhoids, diverticulosis (tiny
pouches that form at weak spots in the colon wall), or inflammatory bowel
disease (colitis).

People having this test will receive a kit with instructions from their doctor's
office or clinic.

The kit will explain how to take a stool or feces sample at home (usually 3
specimens smeared onto a small square of paper). The kit is then returned to
the doctor's office or a medical laboratory for testing.

It is not necessary that the kit be returned immediately because the test is still
accurate if the smeared feces have dried. This is a take-home kit that is used
in the privacy of your own home. An FOBT done during a digital rectal exam in
the doctor’s office is not sufficient for screening. If the FOBT is positive for
blood, then a colonoscopy will need be done to determine the cause of the
blood.

An FOBT done during a digital rectal exam in the doctor’s office is not
sufficient for colorectal cancer screening.
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