X-Message-Number: 11383
Date: Sun, 07 Mar 1999 18:14:14 -0500
From: Jan Coetzee <>
Subject: Colon cancer

"That being the case, it's hard for me to support a societal decision to
significant resources simply to alter how a patient dies"

I found the above quote interesting.


Is Colon Cancer Screening
Justified? Medical Experts Debate

FREEHOLD, N.J., March 5 /PRNewswire/ --
Although recent studies and national guidelines have
recommended routine screening for colon cancer for
individuals who are at least 50 years of age, the question of whether
screening is justified remains the subject of much debate.

``We really have no data that colon cancer screening of any type saves
lives ...
That being the case, it's hard for me to support a societal decision to
significant resources simply to alter how a patient dies,'' said Ronald
L. Koretz,
MD, Professor of Clinical Medicine at the University of California, Los
School of Medicine and Chief of the Division of Gastroenterology at the
View-UCLA Medical Center, during a recent national debate on the issue.

``Average individuals growing up in a high-risk country such as the
United States
should all be offered screening for this very common and very lethal
form of
cancer,`` countered John H. Bond, MD, Professor of Medicine at the
of Minnesota and Chief of Gastroenterology at the Minneapolis Veterans
Medical Center.

Current guidelines now recommend colon cancer screening and Congress
recently gave approval for Medicare coverage. Koretz, however, cited a
of reasons why this screening should not be so easily accepted as
national policy,
including political pressures and the fact that the benefits of
screening are not
supported by firm data, specifically randomized controlled trials. The
absence of
these trials, according to Bond, does not indicate absence of data. To
not act on
the information we now have would be like ``putting one's head in the
sand,'' said

Koretz also believes colon cancer screening does not impact life
According to epidemiological data, half of the deaths for colon cancer
occur in
patients who are at least 75 years of age. Because these patients have
conditions, Koretz believes colon cancer screening may only shift their
cause of
death to something else. ``The decision really becomes: How much do I
want to
spend as a society to prevent somebody from dying of the ravages of
cancer and have them die of a stroke or heart attack instead?'' asked

These and other insights from Drs. Bond and Koretz are featured in the
cover story of ``Medical Crossfire, The Journal of Debates, Peer
Exchange, and
Insights in Medicine'' -- a new specialist and primary care physician
journal that
sponsored the debate.

``With an increased focus in health care on both prevention and
the 'price-to-pay' lesson is especially challenging and deeply
affecting,'' notes
David DePinho, Executive Editor. ``The nature of colorectal cancer
physicians and patients a rare opportunity for early prevention and
detection. But,
when it comes to establishing national policy, what price should society
pay and
how much data is needed to make it worth the cost?''

``Medical Crossfire,'' a publication of Freehold, NJ-based Liberty
Publishing, is
based on the belief that contradictory opinions, insights, and
philosophies fuel
physician learning and understanding. The editors believe that medical
and peer exchange -- the authoritative interaction between specialists
primary care physicians -- has the potential to directly impact patient
care and
medical practices. The monthly journal is circulated to 91,000 primary
physicians nationwide.

Copies of the March issue of ``Medical Crossfire'' featuring the colon
screening debate can be obtained by calling 732-780-9001.

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