The United States spent $43 billion annually on screening to prevent five cancers, according to one of the most comprehensive estimates of medically recommended cancer testing ever produced.
The analysis, published Monday in The Annals of Internal Medicine and based on data for the year 2021, shows that cancer screening makes up a substantial proportion of what is spent every year on cancer in the United States, which most likely exceeds $250 billion. The researchers focused their estimate on breast, cervical, colorectal, lung and prostate cancers, and found that more than 88% of screening was paid for by private insurance and the rest mostly by government programs.
Dr. Michael Halpern, the lead author of the estimate and a medical officer in the federally funded National Cancer Institute’s health care delivery research program, said his team was surprised by the high cost, and noted that it was likely to be an underestimate because of the limits of the analysis.
For Karen E. Knudsen, CEO of the American Cancer Society, the value of screening for the cancers is clear. “We are talking about people’s lives,” she said. “Early detection allows a better chance of survival. Full stop. It’s the right thing to do for individuals.”
Other researchers say the finding supports their contentions that screening is overused, adding that there is a weak link between early detection and cancer survival and that the money invested in cancer testing is not being well spent.
Colonoscopies are a big source of screening costs, accounting for 55% of the total. The cost is driven, Halpern said, by the fees charged by the medical or surgical centers where colonoscopies are performed.
Critics of the current amount of screening said the large price tag researchers documented for screening wasn’t worth the cost.
But supporters of screening point to the recommendations of the U.S. Preventive Services Task Force, an independent and influential group that issues advice on preventive health. The task force’s guidance has broad impact in the United States, setting standards for health insurance coverage. It conducted its own analyses of the data on screening and recommended it to reduce the death rates for four of the five cancers in the study, with evidence strongest for cervical cancer and colorectal cancer. For prostate cancer, it recommended neither for nor against screening and is currently updating its analysis.
This article originally appeared in The New York Times.
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