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Related Experiment Videos

Mandated coverage for cancer-screening services: whose guidelines do states follow?

S S Rathore1, J D McGreevey, K A Schulman

  • 1Clinical Economics Research Unit, Department of Medicine, Georgetown University Medical Center, Washington, DC, USA.

American Journal of Preventive Medicine
|July 29, 2000
PubMed
Summary

State coverage mandates for cancer screening are common and growing, but vary significantly. Most states cover breast cancer screening, yet few cover colorectal cancer screening, with inconsistent guideline use.

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Area of Science:

  • Public Health Policy
  • Cancer Prevention
  • Health Insurance Law

Background:

  • Cancer screening is crucial for early detection and improved outcomes.
  • State-level insurance mandates play a significant role in healthcare access.
  • Understanding these mandates is key to assessing cancer prevention efforts.

Purpose of the Study:

  • To assess the prevalence of state-specific coverage mandates for cancer screening.
  • To analyze the nature and scope of these mandates across different cancer types.
  • To compare state mandates with established clinical guidelines.

Main Methods:

  • Surveyed insurance departments in all 50 states, Washington D.C., and Puerto Rico.
  • Collected and reviewed state codes mandating private insurer coverage for cancer screenings.

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  • Compared identified mandates against American Cancer Society (ACS) and USPSTF guidelines.

    • Main Results:

    • 43 states and D.C. have cancer screening coverage mandates.
    • Breast cancer screening mandates are most common (44 states), followed by cervical (22), prostate (18), and colorectal (1).
    • Most mandates utilize ACS guidelines, with significant variation and no direct adoption of USPSTF guidelines; 57 mandates enacted since 1990.

    Conclusions:

    • State mandates for cancer screening coverage are prevalent and increasing.
    • Significant variations exist in coverage scope and the guidelines used by different states.
    • Further standardization may be needed to ensure equitable access to recommended cancer screenings.