The Affordable Care Act (ACA) made colonoscopy screening available at no cost to eligible Medicare beneficiaries, but a new study published online ahead of print in the Journal of the National Cancer Institute has shown that this benefit did not increase the number of people who undergo the procedure.1

“It was long assumed that cost was a major prohibitive factor for why people didn’t get screened. So the Affordable Care Act made an effort to reduce or remove costs for several highly successful screening and recommended procedures, including mammography and colonoscopy,” said lead investigator Gregory Cooper, MD, co-program leader for Cancer Prevention and Control at University Hospitals Seidman Cancer Center. “This data shows that doing so still doesn’t necessarily guarantee the patients who should be screened will be. Other factors clearly play a role and need to be addressed as well.”

For the study, researchers analyzed data from a sample of Medicare claims from 2009 to 2012 in persons age 70 years or older.

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Results showed that there was a greater uptake in colonoscopy screenings for patients who participated in a yearly wellness visit with their primary care physician, but there was no significant increase in the proportion of Medicare beneficiaries who underwent the test from the time it was available at low or no cost to only one-third of beneficiaries to when low or no cost was offered to all beneficiaries.

On the other hand, the study found that rates of routine mammography significantly increased following the ACA’s mandate of no or low cost screenings for Medicare beneficiaries.

“This study reinforces that we need to do more than simply issue national guidelines for colorectal cancer screenings and make them affordable for everyone in the target population,” Cooper noted. “It is imperative we find a way to increase participation in these important cancer screenings for at-risk populations.”


1. Study: Eliminating cost for colorectal cancer screening doesn’t improve screening rates [news release]. EurekAlert! web site. Posted December 15, 2015. Accessed December 17, 2015.