In May the American Cancer Society lowered the age for people at average risk* to start regular colon
cancer screening at age 45 due to a steep increase of colon cancer patients under 50. This can be done
either with a sensitive test that looks for signs of cancer in a person’s stool or with a visual exam.
People who are in good health and with a life expectancy of more than 10 years should continue to
receive colorectal cancer screenings through the age of 75.
For people ages 76 – 85, the decision to be screened should be based on a person’s preferences, life
expectancy, overall health, and prior screening history.
*Average risk is defined as individuals that do not have:
- A personal history of colorectal cancer or certain types of polyps
- A family history of colorectal cancer
- A personal history with IBD (ulcerative colitis or Crohn’s disease)
- A confirmed or suspected hereditary colorectal cancer syndrome, such as familial adenomatous
polyposis (FAP) or Lynch syndrome (hereditary non-polyposis colon cancer or HNPCC)
- A personal history of getting radiation to the abdomen or pelvic area to treat a prior cancer
The Affordable Care Act (ACA) requires both private insurers and Medicare to cover the cost of
colorectal cancer screening tests, because these tests are recommended by the United States Preventive
Services Task Force (USPSTF). It is important to note that the USPSTF currently recommends that people
of average risk start screening at 50. There’s nothing to stop insurers from covering the test starting at
45 but at this time insurers are not required to do so before age 50.
With this guideline change, the potential for anesthesiologists to provide care for a non-covered service
has increased. Our recommendation has always been to have a “Financial Waiver” signed by your
patients prior to providing anesthesia. Should their insurance deny coverage – RCM will bill the patient
for the agreed upon amount indicated on the Financial Waiver that has been signed by the patient.