(BlackDoctor.org) — Fewer people opted for potentially lifesaving colonoscopies to screen for colon cancer during the recent economic recession, largely because they couldn’t afford to pay high out-of-pocket costs often associated with this test, new research finds.
The problem? African American men have less than a 5-year survival rate for colon cancer, and should therefore be screened for the disease at 40 (10 years earlier than their White counterparts).
About 500,000 fewer Blacks who had health insurance underwent a screening colonoscopy, compared to the two years before the recession began. The study findings appear in the March issue of Clinical Gastroenterology and Hepatology.
“In difficult economic times, people are more likely to forgo necessary medical services if there are high out-of-pocket costs,” said study author Dr. Spencer Dorn, an assistant professor of medicine in the division of gastroenterology and hepatology at University of North Carolina at Chapel Hill. And “colonoscopy is never the most popular service to begin with.”
During a colonoscopy, a doctor looks for abnormalities in the interior lining of your large intestine — the rectum and colon — with a camera after a day-long bowel cleanse or prep. The U.S. Preventive Services Task Force (USPSTF) recommends colorectal screening for people aged 50 and 75, but because of the higher rates of death due to colonrectal cancer, experts recommend that Blacks, particularly Black men, get screened beginning at age 40.
Before the recession, the number of colonoscopies performed each year increased steadily, largely because of general awareness of the test’s benefits and broader coverage by insurance companies, Dorn said.
The new study included data from 106 U.S. health plans on colonoscopy rates before and during the recession among people aged 50 to 64. Those people with out-of-pocket costs of at least $300 were less likely to have a colonoscopy during the recession compared to those with lower out-of-pocket costs, the study showed. Out-of-pocket costs in the study referred to co-insurance payments.