Annual Cost of Cancer Screenings in the United States Estimated at $43 Billion

Teddy Bear Hospital. photo by National Cancer Institute/ Unsplash

A new study from the National Institutes of Health estimates that cancer screenings cost the U.S. healthcare system over $40 billion annually. Based on 2021 data for five common cancers, researchers found that these costs are crucial for policymakers to understand. The findings can inform strategies to improve access to recommended cancer screenings for all Americans.

Researchers calculated the annual cost of initial cancer screenings in the U.S. for 2021 using healthcare survey and cost data. They estimated the total cost by multiplying the number of screenings for breast, cervical, colorectal, lung, and prostate cancer by average insurance costs. The total cost was estimated at $43 billion, with colorectal cancer accounting for 64% of this amount. Private insurance covered most of the costs (88.3%), followed by Medicare (8.5%) and Medicaid/other programs (3.2%). Screening facilities were a major cost driver. Despite the high cost, cancer screenings have been shown to reduce cancer deaths and are often cost-effective, leading to earlier detection, lower treatment costs, and improved quality of life.

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.

And most of this is for colon cancer.

“Remarkably, nearly two thirds of the estimated cost of cancer screening is for a single cancer: colorectal cancer,” said Gil Welch, MD of the Center for Surgery and Public Health. “This is because the most common screening strategy is labor-intensive for both clinicians and patients, necessitating a 24-hour preparation, a trip to a setting similar to an operating theater, and typically anesthesia in order to inspect the entire colon.”

Dr. Welch went on to say that the actual total costs related to cancer should include “subsequent unneeded treatment.”

“Although the treatment of patients who are not destined to develop symptoms or die from their cancer is an unintended side effect of screening,” he said, “the attendant costs are nonetheless attributable to screening. Overdiagnosis and overtreatment are most relevant to breast, prostate, thyroid, and melanoma skin cancer screening. Overdiagnosis is rare in colorectal cancer screening, although the increased rates of colectomy for nonmalignant polyps suggest overtreatment of precursor lesions.”