Cancer Screening Costs 43 Billion Dollars Annually in the United States

A recent study by Halpern and colleagues suggests that the annual cost of cancer screening in the United States may exceed 40 billion dollars. Published in Annals of Internal Medicine on August 6, 2024, the study examined these costs.

The Importance of Screening for Early Cancer Diagnosis

Cancer screening aims to extend survival and improve treatment success by detecting certain cancers at an early stage.

Screening methods such as mammography for breast cancer, Pap smears and HPV testing for cervical cancer, colonoscopy and a new blood test for colorectal cancer, low-dose computed tomography for lung cancer and PSA testing for prostate cancer have demonstrated effectiveness in large clinical studies over the years and are recommended by national health authorities.

These tests improve the chances of successful treatment through early diagnosis and help avoid the substantial treatment costs associated with advanced disease. Regular approved screening is therefore considered a critical step in the fight against cancer.

A Recent Modeling Study

Researchers used national healthcare surveys and cost data to estimate the annual cost of initial screening for five common cancers in the United States in 2021.

They calculated the estimate by multiplying the number of people screened for breast, cervical, colorectal, lung and prostate cancer and healthcare-system-related costs by typical insurance costs in 2021.

• The study found that cancer screening cost approximately 43 billion dollars annually, with approximately 64% of the total attributable to colorectal cancer screening.

Private insurance covered approximately 88.3% of these costs, Medicare 8.5%, and Medicaid and other programs 3.2%.

The researchers noted that fees paid to screening facilities accounted for a substantial share of costs. Although the total is significant, recommended screening reduces cancer-specific mortality, and screening for breast, cervical, colorectal and lung cancers has generally been shown to be cost-effective or cost-saving in the United States. Recommended screening may, for example, increase early detection, reducing treatment costs and financial hardship while improving quality of life.

Commentary

Although 43 billion dollars a year may seem substantial for screening alone, the costs of treating advanced cancers would be much higher without these tests.

These findings may help inform health policies and priorities, particularly efforts to improve equitable access to recommended cancer screening.

In an accompanying editorial by Welch, estimating screening costs was described as a good starting point. However, the estimate may be incomplete because it excludes three important cost components: additional testing after screening, screening people who are ineligible, and overdiagnosis and overtreatment.

The editorial also noted that the study estimated screening costs only for groups considered eligible by the United States Preventive Services Task Force, while data suggest screening of ineligible people is common, particularly among older patients.

It suggested that the considerable resources devoted to screening might be better directed toward broad access to more effective cancer treatment and addressing the social determinants of cancer risk.