Colorectal Cancer Screening

Colorectal cancer is usually found in people age 50 or older, and the risk of getting it increases with age. Medicare covers colorectal screening tests to help find pre-cancerous polyps (growths in the colon) so they can be removed before they turn into cancer. Treatment works best when colorectal cancer is found early.

How often is it covered?

• Fecal Occult Blood Test - Once every 12 months
• Flexible Sigmoidoscopy - Once every 48 months
• Screening Colonoscopy - Once every 24 months (if you're at high risk); once every 10 years, but not within 48 months of a screening sigmoidoscopy (if you're not at high risk)
• Barium Enema - Your doctor can decide to use this test instead of a flexible sigmoidoscopy or colonoscopy. This test is covered every 24 months if you are at high risk for colorectal cancer and every 48 months if you aren't at high risk.

For whom?

All people with Medicare age 50 and older, except there is no minimum age for having a screening colonoscopy.

Your costs in the Original Medicare Plan?

You pay nothing for the fecal occult blood test. For all other screening tests, the coinsurance or copayment applies, but the Medicare Part B deductible is waived. However, if a screening test results in a biopsy or removal of a lesion or growth, the procedure is considered diagnostic and the deductible is applied. If the flexible sigmoidoscopy or colonoscopy is done in a hospital outpatient department or ambulatory surgical center, you pay 25% of the Medicare-approved amount.

What factors increase risk for colorectal cancer?

Risk for colorectal cancer increases if...

• You have had colorectal cancer before, even if it has been completely removed
• You have a close relative, such as a sister or brother, parent, or child, who had colorectal polyps or colorectal cancer
• You have a history of polyps
• You have inflammatory bowel disease (like ulcerative colitis or Crohn's disease).

Risk for colorectal cancer increases with age. It is important to continue with screening, even if you were screened before you entered Medicare.

Your risk for developing colorectal cancer may also increase if you…

• Have a diet high in fat, especially fat from animal sources
• Don't exercise
• Are overweight or obese
• Smoke
• Have 2 or more alcoholic drinks every day

To learn more about colorectal cancer, click on the following links:

• American Cancer Society - Colon Cancer Information
• National Cancer Institute - Colon Cancer Information