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More Tumors Diagnosed After Medicare Screening Expands

More widespread use of colonoscopies, tumors being caught at earlier stage

TUESDAY, Dec. 19 (HealthDay News) -- Since Medicare expanded its coverage of routine colonoscopies, there has been an increase in the number of tumors diagnosed at an early stage, researchers report in the Dec. 20 issue of the Journal of the American Medical Association.

Cary P. Gross, M.D., of Yale University School of Medicine in New Haven, Conn., and colleagues analyzed data from three time periods: 1992 to 1997, when there was no Medicare screening coverage (period 1); January 1998 to June 2001, when there was limited coverage (period 2); and July 2001 to December 2002, when universal coverage was available (period 3).

The average rate of colonoscopy use in period 1 was 285/100,000 per quarter, rising to 889 in period 2, and 1,919 in period 3. Of the 44,924 eligible patients diagnosed with colorectal cancer, 22.5 percent were diagnosed at an early stage in period 1, versus 25.5 percent in period 2 and 26.3 percent in period 3. For patients with distal colon lesions, the Medicare policy change had little impact, but for those with proximal lesions, early diagnosis increased with the extent of Medicare coverage.

"Even a 4 percent increase in the percentage of patients whose cancer is diagnosed at an early stage can have a substantial impact at the population level," the authors write. "Increasing the use of screening tests further has the potential to diagnose many more beneficiaries at an early stage."

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