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Colonoscopies Miss Many Cancers, Study Finds

Rating

4 Star

Colonoscopies Miss Many Cancers, Study Finds

Our Review Summary

Screening has been proven to reduce the risk of death from colorectal cancer.  Yet fewer than 50% of people get screened, lagging behind other cancer screening tests such as mammography and PSA testing. Colonoscopy is considered the reference standard against which other colorectal cancer screening tests are measured, however, it is not perfect. Indeed, new data published ahead of print in this week’s Annals of Internal Medicine suggest that colonoscopy may miss more cancers and polyps than previously thought and reduce colorectal-cancer specific mortality by 60 to 70% instead of the frequently-cited 90% reduction.

This story does a good job of describing the current study and placing it in context with other studies. It explains the relevance of these new findings to the consumer – colonoscopy still prevents cancer deaths, however it has its limitations and people need to adjust their expectations of what it can do for them. Furthermore, the study rightly brings focus to the importance of proper preparation.

The story could have been improved with a few simple additions. First, although the story mentions several alternatives, such as fecal occult blood testing and virtual colonoscopy, it should have mentioned flexible sigmoidoscopy and described the advantages and disadvantages of the different screening methods. And the story could have given the actual costs of colonoscopy.

Criteria

Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story refers to colonoscopies as being “hugely expensive."  It would have been better to tell readers exactly how much they cost.

Does the story adequately quantify the benefits of the treatment/test/product/procedure?

Satisfactory

The story adequately quantifies the mortality benefit from colonoscopy screening. But we wish the story had quantified the benefit in absolute rather than relative terms.

Does the story adequately explain/quantify the harms of the intervention?

Satisfactory

The story mentions the risk of perforations, missed cancers and "unpleasant" preparation as the risks/side effects of colonoscopy.

Does the story seem to grasp the quality of the evidence?

Satisfactory

The story does a good job of describing the current study as well as placing it in context with other studies.

Does the story commit disease-mongering?

Satisfactory

The story does not exaggerate the seriousness or prevalence of colon cancer.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story does a reasonably good job of describing several alternatives to colonoscopy, such as fecal occult blood testing (FOBT) and virtual colonscopy. The story should have also mentioned flexible sigmoidoscopy and described the advantages and disadvantages of the different screening methods as well as critically evaulating the idea of doing a fecal occult blood test between colonoscopies (rather than just the "one MD likes it, one doesn’t" approach that was taken).

Does the story establish the true novelty of the approach?

Satisfactory

Clearly colonoscopy is not a new idea.

Does the story appear to rely solely or largely on a news release?

Satisfactory

Because the story quotes multiple experts, the reader can assume the story does not rely on a press release as the sole source of information.

Total Score: 8 of 10 Satisfactory

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