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 invest significant resources simply to alter how a patient dies" I found the above quote interesting. J.C. 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 this 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 invest significant resources simply to alter how a patient dies,'' said Ronald L. Koretz, MD, Professor of Clinical Medicine at the University of California, Los Angeles, School of Medicine and Chief of the Division of Gastroenterology at the Olive 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 University of Minnesota and Chief of Gastroenterology at the Minneapolis Veterans Affairs Medical Center. Current guidelines now recommend colon cancer screening and Congress recently gave approval for Medicare coverage. Koretz, however, cited a number 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 Bond. Koretz also believes colon cancer screening does not impact life expectancy. 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 comorbid 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 colon cancer and have them die of a stroke or heart attack instead?'' asked Koretz. These and other insights from Drs. Bond and Koretz are featured in the March 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 cost-containment, the 'price-to-pay' lesson is especially challenging and deeply affecting,'' notes David DePinho, Executive Editor. ``The nature of colorectal cancer offers 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 debates and peer exchange -- the authoritative interaction between specialists and primary care physicians -- has the potential to directly impact patient care and medical practices. The monthly journal is circulated to 91,000 primary care physicians nationwide. Copies of the March issue of ``Medical Crossfire'' featuring the colon cancer screening debate can be obtained by calling 732-780-9001. Rate This Message: http://www.cryonet.org/cgi-bin/rate.cgi?msg=11383