Dr. Jianjun Li and colleagues from Maimonides Medical Center in Brooklyn offered free colonoscopies to uninsured patients who were over 50 but too young for Medicare. The average age of the 248 patients screened was 55.

Forty-five percent of patients had polyps, mostly small. However, 5 patients had early stage I or II cancer and 22 had large polyps, bigger than 1 centimeter. Large polyps have the greatest risk of turning into cancer.

Without the free screening, most of the uninsured patients would have had to wait until they were 65 when Medicare would cover the costs. Over ten years, the cancers would have progressed to costly advanced stages and large polyps might have developed into cancer.

The researchers estimate that if the cancers found during early screening and cancers that grew from large polyps had gone undetected until patients were 65, treatment would have cost Medicare $1,295,000. Based on current Medicare reimbursements, the estimated cost of the screening program and surgical treatment for the five early cancers was $390,000. Early screening saved two dollars for every one dollar spent.

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