Colon Cancer Screening Can Soon Be Covered Starting at Age 45
The US Preventive Services Task Force (USPSTF) now recommends starting colon cancer screening at age 45, rather than 50. This proposal has not yet been finalized, but if it is still valid after four weeks of public comment, insurance companies will likely will have to cover the cost of screening 45-year-olds if they have not already done so.
The New York Times notes that this recommendation is unusual for a target group that has called for less screening and not more in some other cases, such as cervical cancer screening and mammography. This makes sense: the task of the target group is to balance the risks and benefits of preventive health care, which depend on the specifics of the procedures, as well as the person’s age and other risk factors.
As we noted in our Colon Cancer Prevention Guidelines , the disease affects people at a younger age than in the past, so 45 is in some ways the new 50. The American Cancer Society has recommended starting screening at 45 years of age since the 2018 guidelines were issued . and several societies have recommended that screening at age 45 be especially important for black Americans. The USPSTF does not suggest different ages for screening based on race, but they note that screening is especially important if you are black:
The CISNET simulation results do not support different race selection strategies. The USPSTF recognizes the higher incidence and mortality of colorectal cancer among black adults and strongly encourages clinicians to provide their black patients with recommended screening, follow-up, and treatment for colorectal cancer. The USPSTF encourages the development of care systems to ensure that adults receive high-quality care throughout screening and treatment, with a focus on black communities with declining health outcomes.
What screening is recommended?
Colon cancer screening can mean a colonoscopy that should be done every 10 years, or stool tests, which are less invasive but need to be done more frequently, usually every year.
The USPSTF draft recommendation includes an outline of the different types of validation and how often each should be done. They give screening an “A” grade for people between 50 and 75 years old and a “B” grade for people between 45 and 49. Generally, anything with an A or B grade should be insured. If you are between 75 and 85 years old, the task force says that you and your doctor should decide together whether screening makes sense for you, and does not make recommendations for screening people over 85 years old.