Sensational language – scary & fawning – in USNWR story on Cologuard colon cancer test

Earlier this month, US News & World Report published a story, “Meet Cologuard: The Colon Cancer Test You Can Take At Home.”

It profiles a man who had what is described as a “gruesome” experience from a colonoscopy 35 years ago – so bad “that he vowed never to have another screening test for colorectal cancer again, despite recommendations that all adults ages 50 and up have a colonoscopy every 10 years.”

There is no explanation of what was so gruesome to keep a man away from colonoscopy for 35 years.  Was his colon perforated?  Was it painful? Did the anesthesia fail?

Many people might describe colonoscopy – or the prep – as unpleasant.  But gruesome?  Without more details, it feels like the story is practicing fear-mongering over one man’s 35-year old anecdote.

But the story quickly transitions from fear-mongering to advertising – just as much health care advertising does.  The story goes on to explain that the man got new health care news from a talk show called “Squawk Box” and pursued a Cologuard, “an at-home, stool-based test for colorectal cancer.”

The story had no independent perspective.

It quotes the CEO of an advocacy group saying “Cologuard is really an opportunity to largely eliminate colon cancer in America.”

Really?

What colonoscopy, flexible sigmoidoscopy, blood stool tests, and the fecal immunochemical (FIT) test could not do, this test will do? (More on this at the very end.)

Here’s what you get when you include independent perspectives.

A few months ago, when the FDA had just approved ColoGuard, a Los Angeles Times columnist wrote, “A good alternative to having a colonoscopy?  Maybe not.” Excerpt:

“(The manufacturer’s) ad said that anyone testing positive with Cologuard should confirm the result with a colonoscopy. It also said that anyone testing negative should still be regularly screened “with a method appropriate for the individual patient,” which in many cases means a colonoscopy.

This raises questions about the value of this “breakthrough test,” which (the manufacturer) is pricing at about $600 per patient — compared with $25 for the traditional stool blood exam.” 

….with each new, state-of-the-art test that comes along, America’s nearly $3 trillion in annual healthcare spending creeps ever higher. This country already pays about twice per person on average than all other developed countries.”

Two other questions hit me as I think about the USNWR story:

• Why didn’t the story mention that the 73-year old man they profiled was fast approaching the often-cited age of 75 to stop having colon cancer screening? Or that after 75 it really should involve a careful shared decision-making encounter with one’s physician, not just hearing an ad on a talk show.

• Why didn’t the story explain that if he uses the ColoGuard test, and it suggests a positive finding, he’s going to go right back to that “gruesome” colonoscopy?

Maybe because it read more like an ad.

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