U.S. News compares accuracy of colon cancer screening tests, but what about costs?
Rating
Fecal Occult Stool Tests for Colorectal Cancer Screening
Our Review Summary
In this brief story, the reporter describes three available fecal occult stool tests used to detect colorectal cancer. The story compares the three on such dimensions as false positives and reductions in cancer deaths.
Since the story is largely descriptive, it is unfortuante that one of the important variables missing from the text is cost; the story only notes that these procedures are covered by Medicare. Readers also would have benefited from a more detailed discussion of each procedure’s debits, as well as of the nature of evidence used to determine each procedure’s accuracy.
Why This Matters
Although most Americans know that a colonoscopy is the gold standard for detecting colorectal cancer, many find prepping for the procedure to be so distasteful that avoidance is a real problem. Fecal stool tests can be a reasonable “plan B” for individuals who need an alternative, as long as folks are aware of the constraints that accompany these tests.
Colon cancer is the third leading cause of cancer death for both men and women, and only removal of premalignant polyps during colonoscopy actually prevents it. These tests, if they reveal something suspicious, will still trigger the need for a colonoscopy.
Criteria
Not Satisfactory
Cost should be a prominent part of this story, as the narrative is engaged in offering comparative advice about procedures, but we only learn, quite late in the story, that Medicare typically covers such screening.
The costs are the key for some patients, especially those with high deductible plans. According to the Healthcare Bluebook, the fair price for a screening colonoscopy is $1383, while stool testing for blood is $46. We could not find FIT on the Blue Book website but found prices online of $99.
Satisfactory
Each of the three tests varies in its ability to catch problems early enough to avoid dying of colon cancer, and this story briefly mentions that variance, with some data for two of the three procedures.
Not Satisfactory
Although the possibility of false positives exists for each test, the writer gets specific about that for only one of them, the FIT-DNA test.
Also, colonoscopy comes with a risk of perforation during biopsy procedures.
Not Satisfactory
The reader will encounter little information about evidence, aside from a mention that, for the Cologuard FIT-DNA test, no long-term studies have been completed. That leads to inferences that the other two tests have survived long-term testing, but have they? While this story was not necessarily meant to be a review of the evidence, some discussion of how rigorous the research is for each test would help readers make informed decisions.
Satisfactory
Detecting signs of colorectal cancer is important.
Not Satisfactory
The two sources commenting on the tests both have received money from Genentech, which makes cancer drugs, and is involved in the business of cancer DNA testing.
Satisfactory
Comparison is the point of the story, and the text does a good job of this.
Satisfactory
These are all available as noted, and Medicare coverage is explained, which is helpful.
Not Applicable
This was a review of the current diagnostic tools for colon cancer, not a new test, so we’ll rate this N/A.
Satisfactory
Such a comparison story is unlikely to stem from a press release.
Total Score: 5 of 9 Satisfactory
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