Colonoscopy Alternatives Less Costly, Invasive

Article excerpt

Byline: Victoria Colliver San Francisco Chronicle

A colonoscopy, a dreaded medical procedure recommended for people 50 and older, is the best, one-shot way to screen and detect colon cancer for now, most health professionals agree.

But an increasing number of experts are beginning to voice support for alternative methods they say could be used more widely to prevent colorectal cancer, which occurs in the colon or rectum. The disease is the third most common cancer diagnosis for men and women and the second leading cause of cancer deaths in men and women combined.

The colonoscopy is the most commonly used colon cancer screening procedure in the country. It allows doctors to examine the entire colon and remove abnormal tissue growths called polpys that can turn into cancer.

A study published in the New England Journal of Medicine last month found that the removal of polyps by colonoscopy appears to cut the death rate from colorectal cancer in half.

But some professionals argue colonoscopy has been promoted as the "gold standard" to the point that other less invasive, lower cost options are routinely overlooked.

"I am not against colonoscopy. I'm against it being called the best test," said Dr. James Allison, professor emeritus of medicine at UCSF and an adjunct investigator at the Kaiser Division of Research. He argued the New England Journal report showing that the colonoscopy is better than other available and recommended screening tests was not a randomized, controlled study.

Despite public urging by health officials, about a third of Americans ages 50 to 75 have never undergone any form of screening for the disease, which claims more than 50,000 lives a year. Studies have shown that people without insurance are more than 60 percent less likely to be screened than those who have health coverage.

But for the insured and uninsured alike, the colonoscopy is unpopular.

Allison, a gastroenterologist, contends more people might get screened if alternatives were encouraged. …