How to stop a silent killer: colorectal cancer screening.

• Position: On First Reading - Brief Article

Because of the clear health advantages of colorectal cancer screening, a growing number of states have mandated insurance coverage for it. Those include Connecticut, Delaware, Illinois, Indiana, Maryland, Missouri, New Jersey, North Carolina, Oklahoma, Rhode Island, Texas, West Virginia, Wyoming and Virginia. Utah's law encourages insurance coverage.

Medicare and Medicaid recipients are covered for all or part of the cost of the testing.

And while insurance mandates make some policymakers uncomfortable about their role in rising health insurance premiums, Senator Robert C. Carpenter, sponsor of the North Carolina law, says that the legislation "will prevent 1,500 to 2,000 deaths a year from colorectal cancer in the state. It's a slow-moving cancer that can be detected early. The insurance companies supported this bill because they saw it as an investment rather than a cost. Screening tests cost less than treatment."

Maryland is taking a comprehensive approach. Money from the tobacco settlement has been pledged to reduce cancer mortality and disparities among ethnic minorities by developing community-based programs to educate and screen people for various cancers.

"Maryland has the third highest colorectal cancer mortality rate in the nation," says Carlessia A. Hussein, who directs the effort. "Since colorectal cancer can be detected early and mortality reduced, it was chosen by most of the local jurisdictions in Maryland as the first cancer to target." She reports that each jurisdiction has developed outreach activities to encourage people to get screened.

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