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Colonoscopy may miss more than 7 percent of cancers


4 Star

Colonoscopy may miss more than 7 percent of cancers

Our Review Summary

The story puts the numbers right in the headline and follows up with more numbers in the lead. The story hits most of our marks and does an especially good job making use of independent voices. We would have liked to see more use of absolute numbers to help readers understand whether, on balance, colonoscopy is still a good way to detect cancer. 


Why This Matters

As the story notes, colon cancer is the second leading killer among all cancers in the US. Detecting it early can save thousands of lives. If there are flaws in the way these screenings are being applied, they need to be documented and remedied. This story does a great job of showing both the flaws and some of the potential solutions. Consumers also should be aware that having a normal colonoscopy does not "guarantee" them they are free of colon cancer for the 10 year interval until the next recommended screening.


Does the story adequately discuss the costs of the intervention?

Not Satisfactory

The story does not discuss costs and should have. If colonscopy is not providing that value that people once thought, it should be examined from a cost basis as well.  Since fecal occult blood stool slide testing is so much cheaper (something referenced in the story but without cost estimates given), this is an even more important issue.

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


The story includes a lot of numbers and, for this reason, we’ll give it the benefit of the doubt on this criterion although we would have liked to have seen more numbers in absolute terms. Saying that women had a 30 percent higher chance of having their cancers missed, for example, sounds like cause for a significant health policy overhaul. But what does that mean in hard numbers? How many women were included in this study, for one. And what was the ratio of missed cancers for them? We’re told 1 in 13 overall, but what was the breakdown for men and for women? It also would have been helpful to see the absolute numbers by gastroenterologist versus primary care physician, as the skill set of the person operating the colonscopy also appears to be a factor.

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

Not Satisfactory

The story does not quantify potential harms from colonscopies, such as colon perforation.

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


The story does a good job of evaluating the quality of the evidence. The writer includes sufficient detail about the study, including the ages of people screened, the total number, the years screened, and other important facts.

Does the story commit disease-mongering?


The story does not engage in disease-mongering. Some mention of how often people live with polyps that don’t become cancer or that, in the later stages of life, don’t merit the risk of a procedure.

Does the story use independent sources and identify conflicts of interest?


This story includes two independent sources to great effect. Without their commentary, readers might be inclined to doubt the results of their colonscopies or seek repeated screenings beyond the recommended schedule. In a short amount of space, this story was able to bring in some valuable perspective on an important study.

Does the story compare the new approach with existing alternatives?


The story says, "Another less expensive test is fecal occult blood testing, which involves taking stool specimens at home and mailing them to the doctor’s office or medical lab. The US Preventive Services Task Force, an independent panel of medical experts appointed by the federal government, recommends screening people aged 50 to 75 for the disease, but does not specify which test is best." There could have been some mention of how effective fecal occult blood testing is and whether similar studies have been done on that type of screening.

Does the story establish the availability of the treatment/test/product/procedure?


The story makes it clear that the screening is widely available and is the standard.

Does the story establish the true novelty of the approach?


The story makes it clear that colonoscopy is the dominant screening for colon cancer.

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


This story does not rely on a news release.

Total Score: 8 of 10 Satisfactory


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