Cancer screening may cost more than $40 billion annually in the United States, according to a recent study published by Halpern et al in the Annals of Internal Medicine.
Study Methods and Results
In the recent modeling study, investigators used national health-care survey and cost resources data to estimate the annual costs of initial screenings for five common cancer types in the United States in 2021. To estimate the costs, they multiplied the number of patients screened for breast, cervical, colorectal, lung, and prostate cancers and associated health-care system costs by typical insurance costs per screen in 2021.
The investigators found that cancer screening cost an estimated $43 billion annually and colorectal cancer represented approximately 64% of the total cost. About 88.3%, 8.5%, and 3.2% of the costs were attributable to private insurance, Medicare, and Medicaid and other programs, respectively.
Further, costs paid to screening facilities were a major driver of the expenses. Although this was a substantial total, the investigators emphasized that recommended cancer screenings have been demonstrated to reduce cancer-specific mortality and screenings for breast, cervical, colorectal, and lung cancers have generally been reported to be cost-effective or cost-saving in the United States. For instance, recommended cancer screenings may increase detection of earlier-stage disease, which may result in decreased treatment costs, decreased financial hardship, and improved quality of life.
Conclusions
The investigators emphasized that their findings may be critical to help inform policy and priorities, including enhancing equitable access to recommended cancer screenings.
An accompanying editorial, published by Welch in the Annals of Internal Medicine, stated that estimating the costs associated with cancer screening could be a useful start but may be an understatement because it does not take into consideration three important components of screening that affect costs: subsequent testing, screening of ineligible patients, and overdiagnosis and overtreatment. In addition, the current study estimated the costs of screening only for the population defined as eligible by the U.S. Preventive Services Task Force; however, data suggest that screening of ineligible patients is particularly common, especially among elderly patients. The editorial author indicated that substantial resources devoted to screening may be better directed toward ensuring widespread access to effective cancer treatment and addressing the social determinants of cancer risk.
Disclosure: For full disclosures of the study authors, visit acpjournals.org.
