NCPA - National Center for Policy Analysis

Screening for Colon Cancer

August 6, 2003

Doctors agree that annual colon cancer screening should begin at age 50 for most people. However, health economists say that the cost of a colonoscopy is too high to justify the test for the average person under 50, despite the fact that 13,000 people under the age of 50 are diagnosed with the disease every year.

Four colon cancer screening tests vary in price, risk and effectiveness:

  • A colonoscopy ($1,000 to $2,000) is the most effective test, but it is invasive, uncomfortable and carries a very small risk of perforation of the colon wall.
  • A virtual colonoscopy ($500 to $1,000) is less invasive but less reliable.
  • A DNA stool test ($795) gives highly reliable positive results but can miss up to one-third of cancers.
  • A Fecal Occult Blood Test ($10) is cheap and easy but has a high false negative and positive rate.

An Indianapolis study of nearly 900 people age 40 to 49 showed that about 10 percent of the subjects had polyps -- which may be a pre-cursor to cancer itself, and which can be removed if identified. None of these patients had cancer and researchers said that most of them probably could have waited until age 50 for a screening.

Another solution for detecting colon cancer earlier is to find those patients with a family history of it, though ovarian, uterine, bladder and stomach cancers can increase risk for colon cancer as well.

Source: Tara Parker-Pope, "Getting Screened for Colon Cancer Isn't Just for the 50-and-Over Set," Wall Street Journal, July 1, 2003.

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