The annual cost for initial cancer screening in the U.S. is nearly as much as treating cancer during the first 12 months after diagnosis, according to a new study.
The Annals of Internal Medicine journal found that initial cancer screenings cost an estimated $43 billion, compared with $52 billion for the first year of cancer treatment.
About 55% of screening costs were for colonoscopies, the main driver of the annual cost total.
Screening for breast, cervical, colorectal and lung cancer has generally been reported to be cost-effective in the United States, noted the researchers, who are affiliated with the National Cancer Institute. The cost-effectiveness of prostate-cancer screening is less clear, they found. The research, based on 2021 data, did not include screening for other types of cancer.
Earlier Diagnosis, Less Aggressive Treatment
Multiple studies have shown that cancer screenings can increase detection at an earlier stage of disease.
“Although earlier stage at diagnosis is not a sufficient outcome for recommending cancer screening, people diagnosed with early-stage versus more advanced-stage disease may have decreased treatment costs, decreased financial hardship, and improved quality of life,” the researchers wrote in their study.
Screening can impact treatment-related morbidities for cancer patients by allowing for less aggressive treatments, noted the researchers.
Private Insurers Pay Most
According to the researchers, the national cost of cancer treatment and survivorship among people aged 65 years or older in the United States was $183 billion in 2015, based on 2019 dollars. But the annual cost to the U.S. healthcare system for cancer screening, treatment and survivorship likely exceeds $250 billion when factoring in people under 65 receiving treatment and the increased use of newer targeted treatments.
The annual cost of cancer screening is largely driven by people covered by private insurance (approximately 68% of all tests and 69% of all screening colonoscopies in 2021), the researchers found. They also noted that private insurance represents more than 88% of the total annual cost of cancer screenings.
None of this surprised them. Why? The majority of people younger than 65 in the U.S. have private insurance. Cancer-screening recommendations include individuals under age 65 while phasing out older seniors. Insured persons with private insurance are charged more for screening tests than Medicare and Medicaid beneficiaries.
According to the study, a screening mammogram for the privately insured is 244% of the cost for Medicare beneficiaries and 312% of the cost for Medicaid beneficiaries. And a screening colonoscopy for the privately insured is 357% and 519% of the cost for Medicare and Medicaid beneficiaries, respectively.
Choose Facilities Carefully
Where you’re screened for cancer (for example, a hospital outpatient facility or ambulatory surgery center) can greatly influence the cost, the researchers noted. When a test such as a CT scan, lung screening or colonoscopy is performed in a facility, physician costs are substantially less than what the facility itself charges, the study found.
The researchers pointed to several limitations in their study. The data they used was self-reported from national health care surveys. And since those studies were conducted in 2021, the rates may have also been lower because of the Covid-19 pandemic. Further, their estimates do not include the follow-up costs for abnormal initial screening results.
More than 2 million new cancer cases and more than 611,000 cancer deaths are projected to occur in the United States in 2024, the researchers noted. The U.S. government’s Cancer Moonshot initiative aims to decrease the cancer mortality rate by at least 50% over the next 25 years and improve the experience of people and their families living with and surviving cancer.
