Engage in Health – the importance of a colonoscopy
The February 23 issue of the New England Journal of Medicine reports the findings of a significant study into the effectiveness of colonoscopy as a preventative tool. The study found a remarkable 53% reduction in deaths from colon cancer among over 2,600 patients over a median of 15+ years when the patient had precancerous polyps identified by colonoscopy removed. In fact, among the survey group, only 12 patients died of colon cancer over the long look back period used in this study.
Today, the recommended approach to colon cancer screening is to have a colonoscopy performed beginning at age 50, with follow-up screenings based on your physician’s advice, typically every 3-5 years. The Patient Protection and Affordable Care Act (PPACA) required preventive services to be covered at 100% beginning September 23, 2010, and colon cancer screening is one of the covered services. So, from a preventive perspective, there should be no economic barriers to receiving the screening. Some physicians may perform a stool examination first, but a colonoscopy is the more thorough exam, and although it too is not perfect it is the best we have.
The unfortunate thing is that according to the CDC, less than 60% of adults over 50 ever have a colon screening, even though early detection of polyps resulted in a 90% survival rate in another study. It is estimated that approximately 51,000 people still die of colon cancer each year, with costs that are significantly higher than the screening itself. Fortunately, awareness continues to increase and compliance rates continue to climb. In fact, March is now the National Colon Cancer Awareness mont when all are encouraged to schedule a screening with their doctor.
While some people avoid the test because they fear it will be painful, uncomfortable or embarrassing, the reality is that having colon cancer is much worse. Many patients do not experience significant side effects and report getting through treatments without problems.
As part of WGA’s Engage in Health strategic approach, we believe that people must be active participants in their own health, including knowing at what age and under what conditions to get screened for preventable conditions. Employers, health plans and other partners, such as wellness vendors, have a role to play in educating employees what is available to them. PPACA has taken away the economic barriers to obtaining most screenings, including colonoscopies. Employers with an older population should consider that key screening test be considered as part of any engagement and reward strategy, e.g. all employees over 50 must have a colonoscopy performed at least every 5 years. If they do it, there are incentives or reward points available. If not, they could be considered “non-participating” – with any attending penalties.
William Gallagher Associates is a leading provider of insurance brokerage, risk management and employee benefits services to firms with complex risks and dynamic needs, within industries that include technology, life sciences, financial risks, health care, renewable energy & clean technology, and environmental services. WGA has offices in Boston, MA; New York, NY; Hartford, CT; Princeton, NJ; Columbia, MD; and Atlanta, GA.