Examining the Potential Impact of New ACS Screening Guidelines on Gastroenterologists
On Wednesday, May 30, 2018, the American Cancer Society (“ACS”) announced a major change to the recommended age for beginning colorectal cancer screening. Previously, the organization recommended that those at average risk of colorectal cancer begin regular screening at age 50. However, prompted by a 2017 study led by ACS researchers and published in the Journal of the National Cancer Institute, which found that new cases of colon cancer and rectal cancer are occurring at an increasing rate among young and middle-aged adults, the ACS is providing guidance to lower the recommended age for beginning screening to 45.
The revised guidance is almost certain to reduce incidence of colorectal cancer for those between ages 45 and 49. That population stands to benefit from early detection and the removal of polyps, which has similarly decreased incidence rates for those over 50. The effect might even be magnified, as the study also found that young and middle-aged adults in the U.S. are at a higher risk of colorectal cancer than earlier generations.
For gastroenterologists (“GI”) and other medical professionals, the ACS’s findings and guidance may impact their practices in several ways:
- The revised guidance will increase the active patient population for the nation’s GI practitioners. According to the New York Times, changing the recommended screening age from 50 to 45 will extend cancer screening to an additional 22 million American adults, potentially straining the patient workload for the approximately 14,000 existing gastroenterologists in practice today. With increased demand for GI services, gastroenterologists may find themselves with increased leverage when negotiating with commercial payors. At the same time, efficient practice management will be required in order for physicians to focus their energy on providing high-quality care.
- The responsibilities for colonoscopy and endoscopy screening may increasingly fall to midlevel providers. Scope-of-practice guidelines currently vary between states, and midlevel providers are not widely performing colonoscopy and endoscopy procedures at the present time. Nevertheless, increasing evidence that midlevel providers have similar outcomes to physicians for those procedures, combined with increased demand for screening services, may support the case for expanding the scope of practice to include procedures performed, in part, by midlevel providers.
- Increased colorectal cancer screening will bring increased attention and investment in GI health. The practice of gastroenterology, accompanying subspecialties, clinical and practice management technology, and research in digestive health are sure to be bolstered by increased patient awareness and engagement. A premium will be placed on innovation, quality, and scale for businesses participating in the GI space, and there will be numerous strategic options for business owners and entrepreneurs seeking partnerships.
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