Colorectal Cancer

Colorectal cancer (cancer of the colon or rectum) is second only to lung cancer in causing cancer-related deaths in the United States. In 2004, more than 53,000 people died of colorectal cancer, according to the Centers for Disease Control and Prevention. The American Cancer Society estimates for 2008 that 158,030 new cases and 49,960 deaths were due to colorectal cancers. 

About 91 percent of new colorectal cancer cases occur in individuals older than 50, and the incidence rate of colorectal cancer is more than 50 times greater in persons aged 60 to 79 than in those younger than 40. The U.S. Preventive Services Task Force recommends screening for colorectal cancer for people ages 50 and older. Colorectal cancer can be prevented and treated through routine screening and early detection. More than one-third of colorectal cancer deaths could be avoided if people over 50 had regular screening tests. 

NMMRA is assisting participating physician practices with their efforts to increase colorectal cancer screening. This support is provided at no charge to physician offices because NMMRA, as the Medicare Quality Improvement Organization for New Mexico, receives funding to focus on colorectal cancer screening from the Centers for Medicare & Medicaid Services.  

Current Medicare coverage for people aged 50 and older includes:

• Fecal Occult Blood Test (FOBT): once every 12 months
• Flexible Sigmoidoscopy: once every 48 months
• Barium Enema: once every 24 months (if high risk); once every 48 months (if not high risk)
• Screening Colonoscopy: once every 24 months (if high risk); once every 10 years, but not within 48 months of a screening sigmoidoscopy (if not high risk)

The costs of CRC screening vary considerably, depending on the screening tests. The most sensitive test is colonoscopy, which is the costliest; the least sensitive test is the FOBT, the least costly. The American Cancer Society reports the following cost ranges for the four predominant CRC screening tests:

• FOBT: less than $20
• Flexible Sigmoidoscopy: $150-$200
• Double-contrast barium enema: $300-$400
• Colonoscopy: $400 or more 

The Clinical Prevention Initiative (CPI), an effort of the New Mexico Medical Society, has a workgroup specifically devoted to promoting colorectal cancer screening. In June 2008, the Colorectal Cancer Screening Workgroup released a  handbook for health care providers with information on colorectal cancer epidemiology, screening, treatment, prognosis, resources, and reimbursement issues. The handbook is accredited for a maximum of four credit hours of continuing medical education.  To access this handbook, click here. For more information on CPI, contact Joan Ford at (505) 828-0237.

For more information on colorectal cancer screening, visit the CMS Web site.

To learn more about NMMRA’s activities to promote colorectal cancer screening, contact the Prevention Team.