The Devil’s choice: Do you set screening criteria to a younger age, raising costs by the additional test and increasing the rate of false positive results, or do you go older and risk more people dying from late diagnosis plus the need for more intensive and expensive treatment? From a cost-benefit perspective, it’s really a lose-lose choice. For the people who die from trying to save costs on testing , well, . . . .
That’s the world in which we live and the choices politicians, health leaders and health insurers have to make. How long you live and the quality of your life isn’t in the equation. How much it costs to keep you alive is.
One of the least pleasant tests is the colonoscopy. (Although I’m told that mashing breasts for a mammogram isn’t all that much fun either.) Typically a colonoscopy involves enema preparation and anesthesia and threading a tiny cable up from the rectum through the colon. Anesthesia isn’t required but many patients prefer it. There are health risks from the anesthesia and potentially from the cable itself damaging the lining of the colon. Like I said, not fun.
The average cost for this test in the US is $2,750, although it can be as high as $4,000.(1) That’s a lot to spend when you hope for no meaningful results.
Almost four years ago, the US Preventive Services Task Force lowered the age for starting colorectal screening from 50 to 45. While two medical organizations took exception to this change, doctors — particularly those is more affluent and urban areas — appear to have adjusted to the new age for starting screening, with a resulting discovery of a larger groups of patients with early cancers requiring treatment.(2) Early detection in the case of most cancers or major diseases typically means better outcomes and lower overall cost of treatment.
Now we have lower cost, FDA-approved options for CRC screening that don’t involve colonoscopies. We have a new blood test (Shield), a new RNA-based stool test (ColoSense) and a second generation DNA stool test (ColoGuard Plus). Some health insurance companies have offered the ColoGuard test for free…
Source: Younger ages and new options for colorectal cancer (CRC) screening – CRAIN’S COMMENTS

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