The cost of initial cancer screenings in the U.S. hit $43.2 billion in 2021. But, according to the Lown Institute, that number could be an underestimate.
In a Sept. 3 article, the institute cites an editorial in the Annals of Internal Medicine by H. Gilbert Wench, MD, pointing out that the estimate doesn't account for overuse of screening or the downstream costs of screening harms. The institute asserts that Americans are "frequently screened for cancer inappropriately" when they are too young, too old or too frequently.
According to one study by Lown, nearly half of older adults were overscreened for colorectal, cervical or breast cancer. Another study found that a quarter of cancer centers don't follow evidence-based federal guidelines for prostate screening, recommending that men be screened for cancer screening without having prior shared decision-making conversations. Another evaluation cited found that across six studies that included 250,00 colonoscopies, the rate of overuse ranged from 17% to 25.7%.
The $43 billion figure, according to the article, also does not include follow-up testing or procedures that often follow screenings, known as "care cascades." One survey published in JAMA Network Open found that out of nearly 400 internists, more than half reported that care cascades caused physical, psychological and financial harm to their patients several times a year.
Overspending associated with excessive or improper screening, Lown contends, raises the question as to how money for cancer prevention and treatment is being directed.
The Lown Institute, citing Dr. Welch's editorial, argues that addressing disparities between race, income and insurance access in cancer treatment would make for stronger investments toward treating cancer in the U.S. The article also recommends re-allocating a portion of the nation's current $43 billion cancer screening spending toward research on treatments for cancer or addressing the risk factors associated with cancer.