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Study: Many elderly get colon screening too often

Rating

5 Star

Study: Many elderly get colon screening too often

Our Review Summary

As the WSJ blog did, this story’s interview quotes provided important perspectives:

  • Researcher Goodwin saying “I was surprised by the magnitude of the issue.”
  • “Robert Smith, director of cancer screening at the American Cancer Society, said some doctors may recommend more frequent colonoscopies because they think 10-year intervals are too risky. Some may think, incorrectly, that finding any growths, even non-suspicious polyps, means a repeat exam should be done within less than 10 years, Smith said. Some doctors also order repeat tests “because they want to bring in income,” he said. Besides being risky and costly, too-frequent screenings make colonoscopy resources less available for people who really need them, Smith said.

 

Why This Matters

This was a well done story about a very well done study with important practice and policy implications.

Criteria

Does the story adequately discuss the costs of the intervention?

Satisfactory

The story stated: “Colonoscopy costs vary widely but typically exceed $1,000. While Medicare rules say the government won’t pay for too-frequent colonoscopies, only 2 percent of the study claims were denied for repeat exams in people without symptoms.”

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

Satisfactory

We’ll give the story the benefit of the doubt for deftly summarizing the story in this way: “The older you are, the more likely you are to die from other causes before cancer becomes deadly, which means the screening procedure’s risks may outweigh its benefits in many aged patients, the study authors said.”

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

Satisfactory

Mixed bag, but we’ll give the story the benefit of the doubt because, in comparison with some stories we reviewed at least this story mentioned what some of the harms were, stating: “The exam is generally pretty safe, but does have risks that occur more often with older patients, including complications from sedation, accidental perforation of the colon and bleeding.”

We wish the story had given some sense of how often these problems occur.

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

Satisfactory

Adequate job explaining the study.

Does the story commit disease-mongering?

Satisfactory

The theme of this story was the opposite of disease-mongering.

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

Satisfactory

The story turned to an American Cancer Society source and to a Medicare spokesperson for comment.

Does the story compare the new approach with existing alternatives?

Not Satisfactory

The story did include the perspective that “while colonoscopies may be overused in the elderly, the exams and other colon cancer screening methods are underused among some groups, including the uninsured, blacks and Hispanics.”

Besides not offering any comparison with other screening methods, the story never mentioned what other screening methods are and it would have taken only a line to do so.

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

Not Applicable

The availability of colonoscopies is not in question.

Does the story establish the true novelty of the approach?

Satisfactory

The relative novelty of this study was clear from the story.

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

Satisfactory

It’s clear that the story did not rely solely on a news release.

Total Score: 8 of 9 Satisfactory

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