The following is a guest post by Dr. Richard Hoffman, one of our expert editors on HealthNewsReview.org.
The New York Times story, “The $2.7 Trillion Medical Bill: Colonoscopies Explain Why U.S. Leads the World in Health Expenditures,” about how the exorbitant costs associated with colonoscopy contribute to the high costs of American medicine has provoked some interesting responses.
Ronald Vender, the President of the American College of Gastroenterology has written a strident letter to the editor in defense of colonoscopy, claiming that colonoscopy is a public health success story — and “the one and only preventive cancer test that has been demonstrated to significantly reduce the incidence of colon cancer and death from the disease.”
Unfortunately, this statement is wrong. The only colorectal cancer screening tests that have been proven efficacious in reducing colorectal cancer incidence and mortality, i.e., evaluated in randomized controlled trials, are the far less expensive fecal blood tests and flexible sigmoidoscopy.
Colonoscopy is being evaluated in several randomized controlled trials in the US and Europe, but incidence and mortality results will not be available for many years.
While Dr. Vender noted that an article published in the New England Journal of Medicine (and reported by the New York Times in an article entitled “Report Affirms Lifesaving Role of Colonoscopy“) was evidence for the benefit of colonoscopy, the study was actually an observational study that was subject to important biases.
While journalistic hyperbole may be disappointing, so are the misleading statements from the American College of Gastroenterology.
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