Colonoscopy Most Effective Screening Test
Colonoscopy, the most expensive and invasive screening procedure for colon cancer, is significantly more effective in identifying "pre-cancerous growths" and tumors than the two most widely used tests, according to a new study published today in the New England Journal of Medicine. The Los Angeles Times reports that Department of Veterans Affairs researchers studied about 2300 "apparently healthy" subjects ages 50 to 75 at 13 VA medical centers. Each participant underwent a fecal-occult blood test, a roughly $10 procedure that tests for blood in a patient's stool, and which the American Cancer Society recommends that all people over age 50 undergo once a year. The researchers also conducted a colonoscopy -- a procedure that examines the entire colon and can cost more than $1,000 -- and "mimicked" a sigmoidoscopy, a technique similar to colonoscopy but that covers only the lower third of the colon; sigmoidoscopy costs about $100 to $300, and the cancer society recommends that older Americans have one every five years. While colonoscopy procedures detected cancer in 24 subjects and pre-cancerous growths in 282 others, the sigmoidoscopy identified "only" 70% of the lesions found by the colonoscopies, and the fecal test detected 24% (Maugh II, Los Angeles Times, 8/23). The study results "could put pressure on more insurance companies to cover" colonoscopy, the AP/Philadelphia Inquirer reports (Johnson, AP/Philadelphia Inquirer, 8/23). To read an abstract of the study, go to http://content.nejm.org/cgi/content/short/345/8/555