Measuring breast, colorectal, and prostate cancer screening with medicare claims data.
BACKGROUND
Evaluating the use and effectiveness of cancer screening is an important component of cancer control programs. Medicare claims may be a useful source of data when screening older populations, but they are limited in terms of completeness and the ability to distinguish screening tests from those provided for diagnosis or surveillance.


METHODS
A review of the major screening modalities for breast, colorectal, and prostate cancer, Medicare's policies for covering these tests, and the procedure codes used to identify them in Medicare claims.


RESULTS
Although Medicare's coverage has been extended to include screening mammography, colonoscopy, sigmoidoscopy, fecal occult blood tests, double-contrast barium enema, and prostate-specific antigen tests, providers have been slow to adopt the corresponding screening codes.


CONCLUSIONS
Challenges persist in measuring screening use, and innovative approaches are required to distinguish screening tests from diagnostic and follow-up evaluations.
Freeman
Jean L
JL
Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas 77555-0460, USA. jfreeman@utmb.edu
Klabunde
Carrie N
CN
Schussler
Nicola
N
Warren
Joan L
JL
Virnig
Beth A
BA
Cooper
Gregory S
GS
D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D006278:Medicare; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D018426:SEER Program; D014481:United States / Q000453:epidemiology