Weekly Health Digest: Colon Cancer Screening and Medicare

A Blood Test to Screen For Colon Cancer May be on the Horizon, a Study Suggests

By Erika Edwards, NBC News

A promising new blood test that can detect colon cancer is working its way through the FDA approval process. The test was created by Guardant Health, and it works by picking up on DNA released by cancerous tumors. A recent study stated the test identified 83% of the cancers later discovered by a colonoscopy. However, it only found 13% of the early-stage polyps that can grow into cancer. The results have led to some mixed reactions among physicians. Some appreciate that more patients may choose to get screened, as the blood test is far more palatable than the gold standard colonoscopy – which often requires patients to take laxatives the day before the procedure and undergo anesthesia during it. Others don’t see much value in a test that struggles to detect the early-stage polyps that are more important to find, as they can be removed to prevent cancer from ever starting. The FDA plans to make an approval decision sometime this year.

— by Andrew Feld

A blood test shows promise for early colon cancer detection

By Gina Kolata, New York Times

While colon cancer screening methods are often successful in early detection, they are not as ubiquitous as one might expect. In fact, only 50-75% of adults are getting screened. These low numbers may sound surprising, as colon cancer is the second-most common cause of cancer-related deaths in America. Dr. Folasade P. May, a gastroenterologist at UCLA Health, asserts that part of the problem in screening uptake is the actual screening mechanism. To get screened for colon cancer, people have to either undergo a colonoscopy or a fecal test. Neither of these methods are easy or particularly easy to talk about. 

With the creation of a blood test screening mechanism, colon screening could become routine, even incorporated into a regular doctor’s visit. The blood test identifies DNA fragments from cancerous cell clusters, or polyps, and it has been found to be quite effective. In a study in the New England Journal of Medicine, a screening blood test was found to be effective at identifying 87% of cancers at a stage early enough for treatment. However, it’s not perfect. The blood test only identifies 13% of large polyps, a number that is much lower than the detection percentage for fecal tests or colonoscopies. This means that the blood test is a good method for identifying early stage cancer but not precancerous cell clusters. If blood tests were incorporated into the list of screening options for colon cancer, this would need to be explained to patients. 

Guardant, the creator of this screening test, is applying for FDA marketing approval. While the tests’ current price is $895, this is not set. Guardant will set its prices after coordination with Medicare and Medicaid. Doctors are hopeful that the introduction of this blood test will make screening more accessible. 

— by Lydia King

When Medicaid Comes After the Family Home

By Paula Span, The New York Times

Starting in 1993, Congress mandated that when Medicare beneficiaries over the age of 55 use long term care, states are required to recover these expenses after their death. This mandate has impacted mainly low and middle income families who cannot afford to pay the debt out of pocket, causing them to lose their homes. Hardship waivers for families are available to reduce these claims, but they can be difficult and unsuccessful. 

Medicaid is the only United States public benefit program that requires that states get money back. Policy is not moving through Congress to stop and prevent the seizure of homes after death due to Medicaid debt. In Illinois, 17,000 families have lost their homes due to Medicare Recovery since 2021. The Stop Unfair Medicaid Recovery Act was reintroduced in Congress, but is struggling due to a Republican-controlled House.

Citizens in the United States may be unaware of the debt they and their families might face due to utilizing Medicaid. A lack of knowledge about Medicaid policies can lead to families losing familial homes, which means more than just money. So, the passage of the Stop Unfair Medicaid Recovery provides the opportunity for families to care for their family members up to their passing, and not have to worry about Medicaid debt or losing their home.

— by Caroline Hansen

Items contributed by: Andrew Feld, Lydia King, Caroline Hansen