Blue Review
A Provider Publication
print page

August 2021

Colorectal Cancer Screening for Members Age 45 to 75

In line with new U.S. Preventive Services Task Force Leaving Site Icon (USPSTF) recommendations, Blue Cross and Blue Shield of Oklahoma (BCBSOK) recommends that colorectal cancer screening for our members begin at age 45 rather than 50. We are updating our Preventive Care Guidelines and our claims processing to reflect this change. Screening should continue until age 75.

Why Screening Is Important
Colorectal cancer is the third leading cause of cancer-related deaths in the U.S., according to USPSTF Leaving Site Icon. New cases among adults younger than 50 are increasing. Colon cancer usually has no symptoms in its early stage. Screening before symptoms present themselves can catch the disease when treatment is most effective.

Recommended Screening

  • USPSTF recommends screening with any of the following tests for members age 45 to 75:
  • Annual guaiac fecal occult blood test (gFOBT)
  • Annual fecal immunochemical testing (FIT)
  • DNA-FIT every one to three years
  • Flexible sigmoidoscopy every five years
  • Flexible sigmoidoscopy every 10 years with annual FIT
  • Computed tomography (CT) colonography every five years
  • Colonoscopy every 10 years
  • Providers may want to discuss earlier screening with members with a family history of colorectal disease or other risk factors. We encourage providers to discuss colon health with all members.

Checking Eligibility and Benefits
For most of our members, colorectal cancer screening is covered at no cost share.

Check member eligibility and benefits using Availity® Provider Portal Learn more about third-party links or your preferred vendor before every scheduled appointment. Eligibility and benefit quotes include members’ coverage status and other important information, such as applicable copays, coinsurance and deductibles. Ask to see members’ ID card and photo ID to guard against medical identity theft.

Some screenings involve a member’s pharmacy benefits in addition to their medical benefits, such as the prep kit for colonoscopies. For details about pharmacy benefit coverage, call the number on the member’s ID card. A member’s pharmacy benefit may be managed by a company other than BCBSOK.