Colonoscopy More Cost-Effective Than New Drugs

A new study gives Americans over age 50 one more reason not to put off having a colonoscopy to check for colon cancer and its forerunners. The screening technique not only is excellent at detecting problems but also appears to be far more cost-effective for most people than new cancer-preventing drugs will probably ever be.

Researchers at the University of California, San Francisco, and the University of Michigan Health System used a computer model to compare the cost-effectiveness of colonoscopy and other screening procedures for colon cancer with that of COX-2 inhibitors, a class of drugs used to treat arthritis but also considered promising in preventing colon cancer.

The data suggest that the drugs are unlikely to be as effective—dollar for dollar—as colonoscopy in cutting cancer death risk for those with average colon cancer risk. Screening plus drugs was most effective but was even more costly.

Two other studies reportedly found that even aspirin had only a modest effect on preventing colon polyps and predicted that aspirin’s effectiveness in reducing colorectal cancer risk would never be superior to the life-saving effect of colon-oscopy.

For an average-risk person, it would cost $20,200 to save one life-year through colonoscopy screening but $233,300 to save the same life-year through COX-2 inhibitors. Even for a person with a higher risk of colon cancer, a colon-oscopy once every five years would still cost less and save more years of life than a daily drug. But the difference was smaller: $3,900 per life-year saved through screening every 10 years or $6,200 for screening every five years, versus $80,300 for drug therapy.