Tag Archives: colonoscopy

AP story focuses on overuse of medical treatments

Lindsey Tanner of The Associated Press addresses the overtesting and overtreatment that have become the focus of several studies and journal articles.

Tanner points to President Obama’s recent medical checkup, during which he had a prostate cancer screening and a virtual colonoscopy – neither of which is normally recommended for patients his age.

Increasingly, experts are questioning whether doctors are practicing “defensive medicine” – ordering tests and treatments to be sure they have covered all the bases even if they are not indicated. Other factors, such as a fee-for-service system and patients who insist on testing and treatments, also come into play.

This week alone, a New England Journal of Medicine study suggested that too many patients are getting angiograms — invasive imaging tests for heart disease — who don’t really need them; and specialists convened by the National Institutes of Health said doctors are too often demanding repeat cesarean deliveries for pregnant women after a first C-section.

Last week, the American Cancer Society cast more doubt on routine PSA tests for prostate cancer. And a few months ago, other groups recommended against routine mammograms for women in their 40s, and for fewer Pap tests looking for cervical cancer.

The focus on overtesting and overtreatment comes the same week CBS News sent out a press release announcing that Early Show anchor Harry Smith underwent a colonoscopy on live television, reported on by Katie Couric. The press release proclaims:

Following Couric’s on-air colonoscopy in 2000, University of Michigan researchers documented a 20% increase in the number of colonoscopies performed across the country, dubbing it “The Couric Effect.”

(Hat tip to Gary Schwitzer)

Parikh: Celebs’ medical advice should be tempered

Writing for Slate, Rahul Parikh chronicles the damage done by medical advice-dispensing celebrities then, acknowledging their influence and staying power, argues that physicians need to learn to work with these prominent folks and their pet causes.

Katie Couric at the 2008 Democratic National Convention in Denver. Photo by Tracy Russo via Flickr.

In a sobering reminder of the line between journalism and celebrity advocacy, Parikh holds up colonoscopy advocate and news anchor Katie Couric as an example of the positives and negatives of celebrities with health-related causes.

Couric partners with doctors instead of undermining them like anti-establishment heroes Jenny McCarthy and Suzanne Somers, but she doesn’t disclose potential colonscopy risks or alternatives to the invasive procedure. Parikh also points out that celebrity sound bites don’t come with the high-speed, stacatto renditions of the small print that are required for other medical advertising, which leaves folks with a one-sided impression of the treatment.

Effectiveness debate over virtual colonscopies

Officials are considering whether or not Medicare will cover virtual colonoscopies, a technology that, while cheaper and far less invasive, may also be less reliable. Los Angeles Times reporter Noam N. Levey looked at how the debate over colorectal screening illuminates the difficulties inherent in the larger discussion about the Obama administration’s push for efficient health-care spending.

According to Levey, “Colorectal cancer is highly treatable if detected early, but it remains the nation’s second deadliest cancer, in large part because half of adults over 50 do not get screened.” Levey reported that patients avoid screening primarily because they wish to avoid the sedation or discomfort that accompany the procedure.

Doctors and researchers do not yet agree on the effectiveness of virtual scanning, and it still requires unpleasant preparations like colon-cleansing and the insertion of air into the intestine. Nonetheless, it promises to offer a relatively enticing alternative to the traditional colonoscopy.

Some studies have indicated that the procedure can detect most polyps as well as traditional colonoscopy. But others have suggested it is not be as good at detecting some smaller polyps.

Disputes over the cost-effectiveness of virtual colonoscopy further complicated the analysis.

The agency’s extensive year-long review of the efficacy of virtual colonoscopy shows just how much budgetary pressure Medicare is under during a period of increased scrutiny and reform.

Medicare, which will spend more than $500 billion this year, is under increasing pressure to contain spending that many experts say threatens the whole federal budget.

Of particular concern has been the rising cost of scans. Medicare spent more than $14 billion on imaging in 2006, double what it spent six years earlier, according to a 2008 report by the Government Accountability Office.