Has the ACA Triggered a Spike in Colorectal Cancer Screenings?

The Affordable Care Act (ACA) lowering certain financial barriers to care seemed to serve as a catalyst for increased colorectal cancer (CRC) screening in individuals of a lower socioeconomic status (SES), since 2010.

The latest analysis published in the journal Cancer was led by Stacey Fedewa, MPH, and her colleagues at the American Cancer Society.

Fedewa was primarily focused on investigating the ACA’s cost-sharing provision that hoped to minimize financial burdens with regards to preventative services like CRC and breast cancer screening.

The team utilized data from the National Health Interview Survey and compared the cases of CRC (15,786 adults 50-75 years old) and breast cancer (14,530 women above 40 years) screening among privately and Medicare-insured adults according to their (SES) both prior to and post ACA establishment.

Results highlighted an increase in CRC screening from 57.3% to 61.2% between 2008 and 2013, especially among the low-income, least-educated, and Medicare-insured individuals.

Although there was allegedly a spike in CRC screening within the population of privately insured and Medicare-insured individuals during the previous 5-year period before the ACA, that increase was apparently standard across socioeconomic platforms.

It’s important to note that in 2008, the Medicare mean cost for mammographies was $82 to $115, whereas the average cost for colonoscopies ranged from $642 to $842. And, prior to the ACA, Medicare enrollees lacking supplemental insurance were required to fork over 20% of the allowable charges.

Apart from the “ACA's removal of financial barriers," researchers speculated the results potentially merely reflected a continuation of underlying trends in CRC screening.

On the contrary, the number breast cancer screening remained the same during that time period. Fedewa and colleagues surmised this could be due to fewer barriers.

Additionally, lower cost and the availability of women's health initiatives like the CDC’s National Breast and Cervical Cancer Early Detection Program likely attribute to the prevalence.