A modeling study suggests that cancer screening in the United States costs more than $40 billion annually. The estimate is based on available 2021 data for costs associated with screening for 5 common types of cancer. According to the researchers, this data is critical to help inform policy and priorities, including enhancing equitable access to recommended cancer screenings. The findings are published in Annals of Internal Medicine.
Researchers from the National Institutes of Health utilized national health care survey and cost resources data to estimate the annual cost of initial cancer screening (screening without follow-up costs) in the United States in 2021. To estimate the cost, the researchers multiplied the number of people screened for breast, cervical, colorectal, lung, and prostate cancer and associated health care system costs by typical insurance cost per screen in 2021 dollars. They found that cancers screening cost an estimated $43 billion annually and colorectal cancer represented approximately 64% of the total cost.
About 88.3% of costs were attributable to private insurance, 8.5% to Medicare, and 3.2% to Medicaid and other programs. Costs paid to screening facilities were a major driver of the expense. The authors emphasize that while this is a substantial total, recommended cancer screenings have been demonstrated to reduce cancer-specific mortality and screening for breast, cervical, colorectal, and lung cancers has generally been reported to be cost-effective or cost-saving in the United States. Further, recommended cancer screenings increase detection of earlier stage disease, which may result in decreased treatment costs, decreased financial hardship, and improved quality of life.
An accompanying editorial says that estimating the cost associated with cancer screening is a useful start but may be an understatement because it does not take into consideration 3 important components of screening that affect costs: subsequent testing, screening of ineligible patients, and overdiagnosis and overtreatment. In addition, the editorialists note that the current study estimated the cost of screening only for the population defined as eligible by the U.S. Preventive Services Task Force, yet data suggests that screening of ineligible patients is particularly common, especially among elderly people. According to the editorialists, the substantial resources devoted to screening may be better directed toward ensuring widespread access to effective cancer treatment and addressing the social determinants of cancer risk.
