The screening program was offered to those with an elevated risk of colon cancer after a 2011 University of Kentucky study that found the advanced colon cancer rate for the uninsured in Kentucky was twice as high as the rate for those with insurance.
Free screening programs for uninsured Kentucky residents increased early colon cancer diagnoses at no additional cost to hospitals in the state, according to a new study.
Published online by the Journal of the American College of Surgeons, the study compared results of the free screening program, which was launched in 2013, with data from the National Cancer Institute's (NCI) Surveillance, Epidemiology, and End Results (SEER) results.
The screening program was offered to those with an elevated risk of colon cancer. Risk factors include family history of the disease, a history of inflammatory bowel disease, and blood in the stool.
The Kentucky patients were more likely to be diagnosed with stage 1 cancers—33% versus 22%—than patients in the SEER-Medicare database.
Based on these finding, researchers calculated a slightly lower cost of care for uninsured patients ($43,126) versus insured patients ($43,736). This "suggests the program is cost-neutral from a system perspective."
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The researchers calculated the costs using SEER-Medicare data on health expenditures during the initial phase of care, including Medicare payments and private insurer payments, as well as patient copayments and deductibles.
They then compared overall costs between patients in the study and the SEER database based on the one-year costs for patients based on the stage of the cancer.
The screening program was a joint project of private groups and the hospital systems of Louisville. It was triggered by a 2011 University of Kentucky study that found the advanced colon cancer rate for the uninsured in Kentucky was twice as high as the rate for those with insurance.
Nationally, racial disparities also endure for colon cancer.
In 2013, colon and rectal cancer incidence was 14% for whites and 20% for African-Americans, who were also more likely than whites to die from the disease, according to NCI.
"This is a promising end point for our program and is entirely consistent with the known effectiveness of cancer screening programs," the authors write.
"Hopefully, these findings can begin a more wide-reaching national conversation about improving access to health care in areas of ongoing disparity."