In May, Governor Glenn Youngkin signed a new law expanding insurance coverage for colorectal cancer screening in Virginia.
Cynthia Yoshida is a nurse and has a sister.
Why was the passage in Virginia important?
Colon cancer screening saves lives. But too many Virginia residents receive a surprise bill from their insurance company or simply cannot afford the screening. The new law requires insurance companies to cover all colon cancer screenings approved by the U.S. Preventive Services Task Force.
There are several options for colon cancer screening, and many Virginians are opting for tests that can be done at home, such as a stool immunochemical test (FIT) or Cologuard. These tests are effective, noninvasive, and more convenient. However, if the test is positive, your screening is not complete until you get a colonoscopy. Here comes the surprise bill. Insurance companies would pay for the FIT or Cologuard test, but would bill you for at least part of the cost of the colonoscopy. The new law goes into effect on January 1 and requires insurance companies to cover the cost of a follow-up colonoscopy.
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Why do I need a colonoscopy if my home stool test is positive?
At-home colon cancer screening tests look for blood or DNA in the stool. If the test is positive, a colonoscopy should be done soon – ideally within six months. The follow-up colonoscopy may detect colon cancer, but more commonly it detects precancerous polyps, which can be removed to reduce your future cancer risk.
What is not covered by this law?
Unfortunately, the cost of a colonoscopy will not be covered if you have had precancerous polyps in the past. Insurance companies consider these types of colonoscopies to be “diagnostic” and still require patients to pay a portion of the colonoscopy out of pocket. Additional legislation would be needed to cover the full cost of screening for patients with a history of precancerous polyps.
Why should you get screened for colon cancer?
Colon cancer is the leading cause of death in men under age 50. Black Americans are more likely to develop colon cancer and die from the disease. Most people who develop colon cancer have no family history of the disease.
Many Virginians are unaware they are at risk for colon cancer or don’t know that regular screenings can lower the risk of colon cancer. Early screening begins at age 45 and can begin earlier if you have a family history of colon cancer. Talk to your doctor about which screening test is right for you, or visit UVa’s colon cancer screening webpage: uvahealth.com/services/colon-health/colon-cancer-screening.
Dr. Cynthia Yoshida is the medical director of the colorectal cancer screening program at the University of Virginia Cancer Center.
