[steve86]

Most of the commenters here are outright rejecting cost-benefit analysis, as though it is some kind of devil's work. But one can't ignore the costs and focus only on potential benefits. We can't all have every test every day nor would we want to. It is very important to note that costs are not just dollar costs, but medical complications as well. The more often you do an invasive screening (at any age) the more likely it is that a medical complication will arise.

The study looked at frequency of screening over different patient ages and what the cost-benefit would be of shorter or longer screening intervals for different age patients. Most people here would agree that scheduling ordinary people for a colonoscopy or pap smear every 30 days would be excessive at age 50 or 70. Why? because the dollar costs would be high, the chance of an infection or perforation for a given patient say after a year or 12 colonoscopies would be quite high, and the screening benefit compared to say a three year scheduling interval would be modest.

One of the things the study looked at was 3 year vs. 5 year vs. no screening at all.

As compared with no screening, guideline-based screening colonoscopy prevented 14 cases of colorectal cancer and 7.7 cancer-specific deaths, and resulted in 63.1 life years gained per 1,000 beneficiaries screened. In contrast, a 5-year screening interval led to prevention of an additional 1.7 cases of colorectal cancer and 0.6 cancer deaths and a gain of 5.8 life years per 1,000 beneficiaries screened.

"To achieve this relatively small added benefit, 783 additional colonoscopies had to be performed, causing 1.3 additional complications," the authors noted.

Reducing the screening interval to 3 years and increasing the duration of screening to age 85 prevented fewer cancers and cancer deaths and further reduced the life years gained per 1,000 patients screened, they added.

I don't see the satanic intent here, just realistic analysis. Also didn't see where anyone is advocating that people be prevented from paying for more frequent screenings if they care to.

Personally, I get none.

[ladyjane]

Also didn't see where anyone is advocating that people be prevented from paying for more frequent screenings if they care to.

You need to get up to speed. Any physician who provides screening that is not mandated will be first fined and then charged with breaking the law.

[Innovative]

Haven’t you heard that “there are liars, d&*n liars, and statisticians” — i.e. you can prove anything with statistics.

And you might view things differently if you were one of the ones whose cancer is discovered too late, when it would have been curable, had it been diagnosed early.

[ConorMacNessa]

I started having PSA'a, at the instance of my PCP, at age 50. Eight years later, in 2005, I had a PSA of 4.5 - no elevated PSA'a previous to that. A Prostate biopsy disclosed nothing of note. In September of 2007 I had another PSA at the same level and went for another Biopsy. I was diagnosed with Prostate Cancer with a Gleason of 9. Wages of Agent Orange.

I went to Hopkins for a second opinion at the instance of my Urologist - diagnosis confirmed. Traditional Radiation therapy 42X and Hormone therapy - Zolodex.

But for the second PSA, I'd be a dead man. I am greatly concerned at the recent noise I've heard on the news regarding calls for the PSA to be dropped as a routine test for men over 50. But for the PSA and the vigilance of my physicians, I would not have survived to see my daughter graduate from University or to see my 67th birthday, coming up in a few weeks.

May I have your your thoughts on the cost-benefit analysis of my having survived the last seven years?

America demands Justice for the Fallen of Benghazi!

O stranger, tell the Lacedaemonians that we lie here, obedient to their command.

Listen, O isles, unto me; and hearken, ye people, from far; The LORD hath called me from the womb; from the bowels of my mother hath he made mention of my name. (Isaiah 49:1 KJV)