High cost of colonoscopy deterring young Americans from testing—and raising cancer risk

Kristina Kelly of Atlanta, Georgia, struggled with haemorrhoids and bleeding after bowel movements for the first year after the birth of her daughter. Her doctor ordered a colonoscopy. The day before the procedure, Kelly found out that she would have to pay $600 for the test, even though she had good, private insurance. She thought about cancelling. “Did I want to spend $600 on that? No. Are there a lot of other things I could have been spending money on? Yes,” says Kelly.

She decided to go ahead with the colonoscopy. The decision might have saved her life. At age 36, Kelly received a diagnosis of stage III colorectal cancer that had spread to one of her lymph nodes.

In the United States, insurance companies often deny people like Kelly, who are younger than 45, sufficient coverage for colonoscopies. These patients pay hundreds, sometimes thousands, of dollars for colorectal cancer testing, even when they have symptoms or a family history of the disease. Physicians and patient advocacy groups say that young adults delay getting colonoscopies because of the cost, contributing to the rising incidence of advanced colorectal cancer and mortality in American adults under 50.

“It really comes down to insurance [companies] recognising that [colonoscopies] need to be paid for,” says Marianne Pearson, senior director of patient navigation at the Colorectal Cancer Alliance, a patient advocacy group. “The diagnosis rates are high, and they’re not stopping. They haven’t slowed down. [Insurance companies] can …