Supreme Court case could threaten colorectal cancer screening access, ACG warns

Editor's Note

The American College of Gastroenterology (ACG) is warning that millions of Americans could lose access to essential colorectal cancer (CRC) screenings if the Supreme Court rules against the role of the US Preventive Services Task Force (USPSTF) in guiding preventive care coverage.

According to the organization’s March 7 announcement, an amicus brief filed in Kennedy v. Braidwood emphasized the significant progress made in reducing CRC deaths through colonoscopy and polypectomy. The brief also highlighted the potential consequences of restricting access to these screenings, particularly the rising incidence of CRC among younger Americans.

The Supreme Court’s ruling, expected this spring, will determine whether USPSTF recommendations continue to shape preventive care coverage under the ACA.

According to ACG, The USPSTF’s recommendation to lower the screening age to 45 has led to increased detection, but disparities persist based on socioeconomic status and geographic location. CRC remains the second leading cause of cancer-related deaths in the US, and diagnoses among adults under 55 have nearly doubled in the past decade. Although overall CRC incidence has declined by nearly 50% due to increased screening, early-onset CRC is projected to become the leading cause of cancer death in people aged 20 to 49 by 2030.

The Affordable Care Act (ACA) currently eliminates cost-sharing for preventive screenings, reducing financial barriers that often deter lower-income patients from getting tested. If the Supreme Court upholds the lower court ruling in Braidwood, CRC screening rates could decline, the ACG warns, leading to more late-stage diagnoses and higher mortality rates. The organization also warns of legal battles over state requirements, noting that 16 states follow USPSTF guidelines for screening mandates.

The ACG emphasizes that the brief did not engage in constitutional arguments, focusing instead on public health implications.