Colorectal Screening: Tests That Can Save Your Life

By Mark McClellan, MD PhD
Administrator, Centers for Medicare & Medicaid Services

You may be surprised to know that colorectal cancer-cancer of the colon, rectum, anus, and appendix-is the third leading cause of cancer deaths among African-American men and women in the United States. In fact, the American Cancer Society reports that colorectal cancer is expected to kill an estimated 7,080 African-Americans in 2005. Factors that increase your risk for colorectal cancer include obesity and cigarette smoking.
The good news is that more than 33 percent of deaths from colorectal cancer could be avoided through regular screening tests. Routine screening tests can help prevent colorectal cancer and can detect the disease in its early stages, when it is more easily treated. Because African Americans appear to be more likely to suffer from this disease than other populations, it is especially important for African-American men and women to understand colorectal cancer prevention.
What tests are covered by Medicare?
Medicare covers colorectal screening tests to help find pre-cancerous polyps (growths in the colon) so they can be removed before they turn into cancer. Medicare covers four screening tests for colorectal cancer:
 Fecal Occult Blood Test-Once every 12 months
 Flexible Sigmoidoscopy-Once every 48 months (or, once every 10 years after a screening colonoscopy)
 Screening Colonoscopy-Once every 24 months (if you’re at high risk). Once every 10 years, but not within 48 months of a screening sigmoidoscopy (if you’re not at high risk)
 Barium Enema-Your doctor can decide to use this test instead of a flexible sigmoidoscopy or colonoscopy. This test is covered every 24 months if you are at high risk for colorectal cancer and every 48 months if you aren’t at high risk.
Who should get tested for colorectal cancer?
Colorectal cancer is usually found in people age 50 or older, and the risk of getting it increases with age. Medicare covers colorectal screening tests for all people with Medicare age 50 and older, except there is no minimum age for having a screening colonoscopy. Risk for colorectal cancer increases if you or a close relative have had colorectal polyps or colorectal cancer, or if you have inflammatory bowel disease (like ulcerative colitis or Crohn’s disease).
For more specific information about these benefits and other Medicare preventive services, including Medicare’s upcoming prescription drug coverage in January 2006, visit us at www.medicare.gov on the Web, or call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.