Decrease in CRC Resections Tied to Medicare-Covered Screening

Medicare payment for screening colonoscopy in 2001 linked to decreases in proximal resection

WEDNESDAY, Oct. 24 (HealthDay News) -- The rates of resection for distal and proximal colorectal cancer (CRC) decreased from 1993 to 2009, with rates of proximal resection decreasing significantly from 2002, after implementation of Medicare payment for screening colonoscopy, according to a study published in the November issue of Gastroenterology.

Parvathi A. Myer, M.D., from the Stanford University School of Medicine in California, and colleagues examined U.S. trends in resection rates for proximal versus distal CRC in the context of national CRC screening data before and after Medicare's decision to pay for screening colonoscopy in 2001. Age-adjusted rates of resection in adults were estimated from the Nationwide Inpatient Sample from 1993 to 2009.

The researchers found that, for distal CRC, the resection rates decreased from 38.7 per 100,000 persons in 1993 to 23.2 per 100,000 persons in 2009. The annual decreases were 1.2 percent from 1993 to 1999 and 3.8 percent from 1999 to 2009. For proximal CRC, the rate of resection decreased from 30.0 per 100,000 in 1993 to 22.7 per 100,000 in 2009, but significant annual decreases of 3.1 percent were only seen from 2002. Among younger adults, the rates of resection increased, with the decrease in rates of resection for CRC seen among adults aged 50 years and older.

"These findings support the hypothesis that population-level decreases in rates of resection for distal CRC are associated with screening, in general, and that implementation of screening colonoscopy, specifically, might be an important factor that contributes to population-level decreases in rates of resection for proximal CRC," the authors write.

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