of Central Pennsylvania, PC
Anyone over the age of 50 - you are considered at average risk for developing colon cancer
Anyone with one of the following conditions - you are considered at elevated risk for developing colon cancer:
Colon cancer is the most common cancer in the United States. It is the second most common cause of cancer death in the United States (after lung cancer). If discovered early, however, colon cancer is also one of the most curable of malignancies. Most colon cancers tend to start out as colon polyps, or benign growths, in the lining of the colon (large intestine). If one of these polyps (or growths) is discovered early and removed, it can never develop into a colon cancer. The efficacy of screening colonoscopy to prevent colon cancer in the general population has been amply demonstrated in multiple medical studies.
Screening colonoscopy is a procedure where the colon is cleansed, then, after appropriate sedation is administered, an instrument called a colonoscope is inserted into the rectum. This instrument has a video camera at the tip, and is inserted to a distance adequate to view the entire colon. If any small growths or polyps are found, they are typically removed during the colonoscopy. Colonoscopy can also diagnose other conditions, including inflammatory bowel disease, diverticulosis, and hemorrhoids.
The American Cancer Society recommends screening colonoscopy for all adults over the age of 50, and every 10 years thereafter if the colonoscopy is normal. If you fall into a high risk category, then earlier screening colonoscopy may be warranted. If an abnormality is found, more frequent surveillance colonoscopy may be indicated (typically every 3 to 5 years if a polyp is found).
Colonoscopy is performed in a licensed endoscopy center, either hospital-based or free standing. Most colonoscopies are now performed in free-standing endoscopy centers; when and where your colonoscopy are performed will be determined after your pre-screening visit with your gastroenterologist.
Although all insurers will cover colonoscopy for an indication (for example, change in bowel habits or abdominal pain), some will not reimburse for colonoscopy for "average risk" screening purposes (when the patient has no symptoms or one of the high-risk conditions noted above). Although the medical literature clearly supports the benefit of average risk screening colonoscopy, some insurers have been slow to recognize that benefit and will not cover that procedure. In those situations, the patient is responsible for the costs of the screening colonoscopy; for many, this may be significant factor in the decision whether to proceed with this beneficial procedure. There has been legislation pending in the Pennsylvania Legislature to require all insurers doing business in the Commonwealth of Pennsylvania to provide coverage for screening colonoscopy; this legislation has not yet passed, however.
Strangely enough, some insurers do cover screening colonoscopy at 100 percent, but diagnostic colonoscopy at a lesser percent (typically 80 to 100 percent, depending upon the individual plan). Our office will do its best to help you remain informed about your own insurance plan.
On July 1, 2001 Medicare recognized the value of screening colonoscopy for the prevention of colon cancer, and now provides payment for screening colonoscopy.