The Boston Globe

March 13, 2008, Elizabeth Cooney

Mass. gets an "F" in colon cancer screening for not mandating insurance coverage

Massachusetts gets a flunking grade for colon cancer screening according to a group that tracks whether states require insurance companies to pay for the tests.

The Colorectal Cancer Legislation Report Card, issued Tuesday by a coalition of advocacy organizations and professional associations, groups Massachusetts with 25 other states that fail to mandate coverage for comprehensive screening tests, including colonoscopy. Nineteen states earned "As" for enacting laws that also look ahead to future recommendations on detecting colon cancer.

Colon cancer is diagnosed in about 150,000 people a year in the United States and about 50,000 people will die from it. When found early, the success rate for treatment is 90 percent, according to the American Cancer Society, part of the coalition.

The US Centers for Disease Control and Prevention recommends that adults 50 and older and people with a family history of the disease have regular tests, including colonoscopies to find and remove polyps that can be precursors to cancer. Many insurers cover colonoscopies only for high-risk patients, according to the Health Insurance Association of America.

Massachusetts Health Quality Partners, a group made up of insurers, physicians, hospitals, consumers, and government agencies, has issued guidelines that call for the same level of colon cancer screening as recommended by the CDC.

A 2006 analysis by the American Cancer Society found that screening rates in "A" states have increased 40 percent faster than in "D" or "F" states. The report card gives a "D" to states that have passed laws recommending, not requiring, screening coverage.

An editorial in today's Globe calls for coverage of virtual colonoscopies, too. The CT scan examinations require the same day-before preparation but take only minutes to perform and do not require sedation. If a polyp needs to be removed, a regualar colonoscopy is done.

"Insurance companies generally cover the regular kind, but not the virtual colonoscopy," the editorial says. "But if millions of people continue to shun them, the virtual option is much better than nothing. Both kinds should be covered by insurance to spare older Americans the ordeal of the advanced form of the disease."