Colonoscopy proves superior to other, cheaper tests in finding colon cancer

Associated Press Colonoscopy proved far superior to two other common tests for colon cancer in a study that could put pressure on more insurance companies to cover the expensive screening method.

Government researchers found that the two most widely used screening tests for colon cancer together missed one-quarter of the tumors and precancerous growths detected by colonoscopy.

Experts consider colonoscopy the "gold standard" test for the nation's No. 2 cancer killer, but they have been trying to establish with more certainty which method really is the best.

Medical guidelines generally call for annual testing for blood in a patient's stool and, every five years, a sigmoidoscopy, or examination of the lower colon, both starting at age 50. Some guidelines recommend colonoscopy as a routine test; others recommend it only for people who run a high risk of colon cancer, such as those with a family history of it, those who have had previous growths, or those who show signs of cancer during the stool test or a sigmoidoscopy.

The latest attempt to settle the uncertainty compared colonoscopy to a combination of sigmoidoscopy and the fecal blood test. The study, conducted by the Department of Veterans Affairs, backs the use of colonoscopy as a routine screening test.

"Colonoscopy currently is the best available test that we have," said Dr. David A. Lieberman, who led the study as chief of gastroenterology at the Portland Veterans Affairs Medical Center in Oregon. The study "makes a case for at least considering colonoscopy as a screening test beginning at age 60."

Colonoscopy involves the use of a flexible, lighted tube that lets a doctor see the sedated patient's entire colon and immediately remove any growths. Costing at least $1,000, colonoscopy is considered 95 percent accurate and is recommended by the American Cancer Society every 10 years, starting at age 50 for people who are not at high risk for colon cancer.

Sigmoidoscopy, which costs $100 to $200, uses a less-sophisticated viewing tube and cannot probe the colon's top two-thirds, where growths become more common, dangerous and hard to detect with age.

HMOs generally cover the use of colonoscopies for routine screening. Traditional fee-for-service insurance companies generally pay for them only for high-risk patients.