Q. Why is colorectal screening important?

A. Colon cancer is the second highest cancer killer in America. 55,000 Americans will die this year because of colorectal cancer.

Q. Why have screening tests done?

A.

• Screening can prevent cancer by removing precancerous growths (polyps)*
• Early detection diagnosis of cancer before it has a chance to spread leads to better outcomes and improved survival.

* Polyps are growths within the colon that occur frequently as people grow older. While polyps often are benign, they also can be precancerous. Deaths and later surgeries can be avoided if polyps are detected and removed in their benign, precancerous, or early cancerous stages.

Q. What are my options?

A. Your doctor may suggest one or more of the following tests:

• Fecal Occult Blood Tests – This test involves examining a small sample of stool to see if any hidden blood is present. Medicare pays for this test when ordered by your physician.
• Flexible Sigmoidoscopy – This is a flexible telescope examination of the lower one-third of the colon. This is a new Medicare benefit covered once every 4 years for average risk patients over the age of 50. Generally, no Medicare pre-certification is needed.
• Screening Colonoscopy – This is a more thorough examination of the entire colon and allows the doctors also to remove polyps if they are encountered. This will be covered once every 2 years for high-risk patients over the age of 50 (see definition below). Generally, no Medicare pre-certification is needed.
• Barium Enema – This is an x-ray examination of the colon. It will be authorized only upon written certification by your physician that the benefit from barium enema examination is equal to or greater than the screening potential for colonoscopy or sigmoidoscopy. Medicare authorization is always required.

Q. Who are high-risk patients?

A. Medicare has defined high-risk individuals as those who have one or more of the following:

• Those with a close relative (parent, child, siblings) who has had colon cancer or certain colon polyps
• Those with other inherited forms of colon polyps or colon cancer
• Those with personal history of colon or rectal cancer or colon polyps
• Those with inflammatory bowel disease including Crohn’s disease or ulcerative colitis
• Ask your physician if you are considered a high-risk individual.

Q. What should I do now?

A. Ask your physician or healthcare provider about this important new Medicare benefit and ask them to help you decide which test it right for you.

Remember, together we can prevent and detect colon cancer.

Colorectal Cancer Screening….. If you won’t do it for yourself, Do it for the one’s who love you!

Craig Winkel, MD
Dr. Winkel is Past Professor and Chair of the Department of Obstetrics and Gynecology at Georgetown University in Washington, DC.