Freeman Jean L, Klabunde Carrie N, Schussler Nicola, Warren Joan L, Virnig Beth A, Cooper Gregory S
Sealy Center on Aging, University of Texas Medical Branch, Galveston, Texas 77555-0460, USA.
Med Care. 2002 Aug;40(8 Suppl):IV-36-42. doi: 10.1097/00005650-200208001-00005.
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.
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.
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.
Challenges persist in measuring screening use, and innovative approaches are required to distinguish screening tests from diagnostic and follow-up evaluations.
评估癌症筛查的使用情况和有效性是癌症控制项目的重要组成部分。在筛查老年人群体时，医疗保险理赔数据可能是有用的数据来源，但在完整性以及区分筛查测试与诊断或监测所用测试的能力方面存在局限性。
对乳腺癌、结直肠癌和前列腺癌的主要筛查方式、医疗保险涵盖这些测试的政策以及用于在医疗保险理赔中识别它们的程序代码进行综述。
尽管医疗保险的覆盖范围已扩大到包括乳腺钼靶筛查、结肠镜检查、乙状结肠镜检查、粪便潜血试验、双重对比钡灌肠和前列腺特异性抗原检测，但医疗服务提供者采用相应筛查代码的速度一直很慢。
在衡量筛查使用情况方面仍然存在挑战，需要创新方法来区分筛查测试与诊断及后续评估。
