The Glaring Issue Around Escalating Follow-Up Costs, When Cancer Screening Reveals Potential Anomalies.

The Glaring Issue Around Escalating Follow-Up Costs, When Cancer Screening Reveals Potential Anomalies.

Even though the White House is already pushing for prevention by offering free cancer screening and emphasizing the importance of early treatment, under the Cancer Moonshot Initiative - there is much work to be done towards protecting privileged groups. 

As part of the Affordable Care Act, patients are already provided with free screening as well as certain types of preventative care. Moreover, this provision ensures that common obstacles in medical treatment such as co-pays or insurance plan deductibles won’t pose a major hurdle, in such cases. 

However - when the initial screening reveals potential anomalies, a host of subsequent exams will be required that will tend to add up significantly to the cost of treatment. Such costs can still easily escalate to the degree of sometimes being inaccessible to many patients, in situations where time is very much of the essence, and proactive action must be taken as swiftly as possible. 

According to recent research from the University of Michigan, there are certain additional measures that policymakers could push forward that would contribute significantly to reducing inequalities, and further reduce the mortality associated with this disease.

“For those who have an abnormal initial cancer screening test, it makes no sense to put a barrier in place for that individual to complete the diagnostic process,” said A. Mark Fendrick, M.D., who helped lead the new studies. “The main goal of cancer screening is to detect those people who could benefit from early detection.” 

In this research, the potential cost and frequency of follow-up tests were measured, in cases encompassing cervical cancer as well as colon cancer, lung cancer and breast cancer. 

It was observed that indeed there are many unreasonable financial barriers in place that would best be addressed by the government. 

Such an approach would likely increase the number of patients (most notably members of underserved populations, and females in particular) who would be able to promptly follow up their initial screening with the appropriate tests, whenever necessary. 

This approach would both cut down on the mortality as well as the cumulative cost of medical treatment, which tend to rise significantly in proportion to the progression of the disease. 

Analyzing the Costs Associated to Treating Cervical Cancer

A paper published in 2022, in collaboration with reputable obstetrician/gynecologists, set out to determine the expenses currently burdening women whose free cervical cancer screening requires additional tests. At this time, women are required to pay directly for more thorough exams, such as the colposcopy. 

This medical exam (which includes a biopsy along with other procedures) is required as a follow-up to any routine cervical exam, HPV test or Pap smear that reveals anomalies. The average cost for a self-contained colposcopy (with no additional procedures) is on average $112, rising to $155 when there’s a requirement to send cells for pathological exams. 

Subsequent procedures will have a cost in the hundreds of dollars range, and additional treatment after a problematic biopsy will easily push the medical bill over one thousand dollars - all of which amount to out-of-pocket expenses that have been consistently rising over the past years. 

“The recent release of the federal guidance to eliminate cost-sharing for follow-up colonoscopy, after a commercially insured individual receives a positive, non-invasive test result, is an important step forward,” said Fendrick. “However, there still is work to be done, and evidence to support comparable policies to remove out-of-pocket costs for follow-up testing for the three other cancers for which initial screening tests are fully covered.”

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