Market for colorectal cancer screening by endoscopy in the United States

In the United States, colorectal cancer (CRC) ranks third among all cancer sites in incidence, and second in cancer-related mortality. Although screening reduces CRC incidence and mortality, current screening rates among the average-risk population are low. The traditional way of promoting CRC screening has been to educate healthcare providers and the public on its benefits, available screening procedures, and current guidelines. In this paper, we focus on economics and provide an overview of some key factors that affect the demand for and the supply of CRC screening by endoscopy. Factors affecting the demand for endoscopic CRC screening include the number of people for whom screening is recommended, consumers' income and health insurance status, time and travel costs, prices of non-endoscopic CRC screening tests, and personal preferences and perceived quality of care. Factors influencing the supply of endoscopic screening include the availability of endoscopic providers, increased efficiency, procedure costs, current reimbursement rates for endoscopic procedures, and technical progress. The volume of screening tests in the market is determined jointly by the collective demand and supply decisions of consumers and providers. The discussion includes policy implications for the current effort to promote widespread use of CRC screening in the United States.