Author Affiliations: Division of Colorectal Surgery, Department of Surgery, and Michigan Surgical Collaborative for Outcomes Research and Evaluation, University of Michigan, Ann Arbor.
Starting in July 2001, the Medicare Benefits and Improvement Act expanded Medicare coverage to include colonoscopy for colorectal cancer screening among average-risk beneficiaries older than 50 years.1 This legislation has several important implications. From a clinical standpoint, colonoscopy is the most sensitive test available for diagnosis of early stage, curable colorectal neoplasms. Colonoscopy is also the only cancer screening test that is potentially preventive because it permits removal of premalignant lesions. Some have related the decrease in colorectal cancer incidence and mortality to screening of the distal colon (such as barium enema and sigmoidoscopy)2; colonoscopic screening of the entire colon is intended to improve this further by addressing right-sided lesions.
Morris AM. Medicare Policy and Colorectal Cancer ScreeningWill Changing Access Change Outcomes?. JAMA. 2006;296(23):2855-2856. doi:10.1001/jama.296.23.2855