Costs out of pocket are incurred after free cancer screening examinations


If free screening tests for certain types of cancer produce worrying results, follow-up care can still cost hundreds of dollars, according to research.

This month, eleven years ago, the scans and exams that have the best ability to detect the early signs of cancer were made available free of charge to many American adults.

The two new studies could support efforts to ensure that patients are following up abnormal test results and not delaying treatment for reasons of cost. Such delays could cause cancer to go undiagnosed and progress, potentially leading to poor patient outcomes and high medical costs.

The studies look at the expenses billed to older adults who had CT scans to screen for lung cancer and women after an abnormal Pap smear or cervical exam.

The first paper, led by radiologists Tina Tailor of Duke University and Ruth Carlos of Michigan Medicine at the University of Michigan, examines what patients are billed for for lung biopsies and other invasive procedures to follow up on an abnormal lung CT scan were asked. It appears in Journal of the American College of Radiology.

Overall, 7.4% of patients who underwent lung cancer screening CT received at least one invasive follow-up exam. While 20% of this group were diagnosed with lung cancer, the rate of post-screening CT scanning is higher than in clinical trials of this type of screening. Such studies have demonstrated the value of lung CT screening in certain older adults and resulted in free access in 2013.

Over half of patients who had surgery after their lung scans were asked to pay something, sometimes hundreds or even thousands of dollars out of pocket. Of the patients in the study, 40% paid nothing for their follow-up care.

Now that more American adults are eligible for free lung cancer screening based on new knowledge about the ability to detect disease early, the authors say insurers should consider ways to reduce the cost of those with abnormal scans who need follow-up care. to reduce to determine if cancer is present.

The second article published in the magazine Obstetrics & Gynecology by a team led by University of Michigan Professor of Internal Medicine A. Mark Fendrick and Assistant Professor of Gynecology Michelle Moniz, studied what women paid out of pocket for a type of cervical exam called a colposcopy. If a Pap smear, HPV test, or routine cervical exam gives abnormal results, a colposcopy may include a biopsy or other procedure.

Women who had a colposcopy done without further surgery paid an average of $ 112, while those who had cells removed for further examination paid an average of $ 155. Those who had other procedures had to cost hundreds of dollars more – and those expenses rose sharply over the 13 years studied. By 2019, a woman who received extra care beyond a biopsy could expect a total bill of nearly $ 1,000.

“It has been shown that much lower costs prevent women from getting recommended health care,” says Moniz. “So it is high time to remove financial barriers to recommended cancer prevention treatments.”

“The Affordable Care Act calls for improved care for over 150 million Americans, including initial screening tests for breast, cervical, colon and lung cancers,” says Fendrick. “Because screening for these cancers often involves multiple steps, health insurers should remove barriers that can create financial difficulties or prevent a person from completing the screening process.”

Source: University of Michigan

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