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     COMMENTS: Is Couricís Math Correct?

The widowed Couric has plenty of personal motivation to continue the public health activism she began on NBC's Today to try to prevent colon cancer deaths. Now at CBS, she persisted with her Conquering Colon Cancer series urging every fiftysomething to undergo colonoscopy screening.

Couric cited Centers for Disease Control statistics that 154,000 patients are diagnosed with colon cancer each year. She said that early diagnosis costs $30,000 per patient but late diagnosis costs $120,000. Early diagnosis is achieved via colonoscopy, which costs $1,200 per screening.

Couric claimed that colonoscopies not only save lives but they save money too. According to our calculations, in order for Couric's "money saving" claim to be true, every $90,000 in colonoscopy screening (75 patients) would have to render one early diagnosis. But at a one-in-75 incidence, the 154,000 each year who contract the disease would be found in a population no larger than 11.5m.

Did Couric's zeal lead to her overstate her case? Surely Couric's activism for universal screening is targeted at many more than 11.5m potential colonoscopies? At $1,200 per colon how can these procedures possibly save money? If there are any public health epidemiologists reading this, could you please check Couric's math?

     READER COMMENTS BELOW:

Well, at age 50 my doctor said if I had a colonoscopy every five years, he would guarantee that I would die of something else. He is gone now, but I am nearing 85 and healthy.
$1200 for the procedure... HA. After everyone got their hand out, mine was closer to $3000. That includes my regular dr for "pre-op", anesthesia dr (darned if I'm going to have this procedure awake), and the dr who did the procedure. My insurance covered very few of these charges. Even so, I'm glad I had the procedure.
Early discovery makes the treatment less costly. Docotors don't just diagnose and send home, they opperate. Catching it early means an easier procedure and less recovery, etc. And the more screenings done would lead to a lower price per patient (eventually).
My sister Rachel, who is a National Health Service bureaucrat in London, tells me that the British disagree with universal colonoscopies. Instead, they conduct screening for blood in the stool and only perform a colonoscopy for the 2% of the population with a positive blood test. Out of that 2%, half have either pre-cancerous polyps or colon cancer itself. The ratio of polyps-to-cancer is 4-to-1.

She did not have the data on how many colon cancers occur among those without blood in the stool.



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