Prevention and Treatment of Colorectal Cancer: Pay Now or Pay Later
Authors: James D. Lewis
Journal: Annals of Internal Medicine (2000)

Editorials17 October 2000Prevention and Treatment of Colorectal Cancer: Pay Now or Pay LaterJames D. Lewis, MD, MSCEJames D. Lewis, MD, MSCEUniversity of Pennsylvania School of Medicine; Philadelphia, PA, USA 19104 (Lewis)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-133-8-200010170-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Colorectal cancer, the second most common cause of cancer-related death in the United States (1), is well suited for prevention with screening programs. It has a high incidence, is fatal when diagnosed at an advanced stage, is curable when diagnosed at early stages, and passes through a detectable asymptomatic stage; moreover, screening tests with varying degrees of sensitivity and specificity are readily available.The basic principle underlying colorectal cancer screening programs is that removal of precancerous adenomatous polyps prevents the development of most colorectal cancers (2). In addition, identification of colorectal cancer at an early stage allows for cure of ...References1. Ries L, Kosary C, Hankey B, Miller B, Clegg L, Edwards B, eds. SEER Cancer Statistics Review, 1973-1996. Bethesda, MD: National Cancer Institute; 1999. Google Scholar2. Winawer SJ, Zauber AG, Ho MN, O'Brien MJ, Gottlieb LS, Sternberg SS, et al . Prevention of colorectal cancer by polypectomy. The National Polyp Study Workgroup. N Engl J Med. 1993;329:1977-81. CrossrefMedlineGoogle Scholar3. Müller AD, Sonnenberg A. 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Veterans Affairs Cooperative Study Group 380. N Engl J Med. 2000;343:162-8. CrossrefMedlineGoogle Scholar13. Sonnenberg A, Delcò F, Inadomi JM. Cost-effectiveness of colonoscopy in screening for colorectal cancer. Ann Intern Med. 2000;133:573-84. LinkGoogle Scholar14. Tengs TO, Adams ME, Pliskin JS, Safran DG, Siegel JE, Weinstein MC, et al . Five-hundred life-saving interventions and their cost-effectiveness. Risk Anal. 1995;15:369-90. CrossrefMedlineGoogle Scholar15. Lewis JD, Asch DA. Barriers to office-based screening sigmoidoscopy: does reimbursement cover costs? Ann Intern Med. 1999;130:525-30. LinkGoogle Scholar16. Russell LB, Gold MR, Siegel JE, Daniels N, Weinstein MC. The role of cost-effectiveness analysis in health and medicine. Panel on Cost-Effectiveness in Health and Medicine. JAMA. 1996;276:1172-7. CrossrefMedlineGoogle Scholar17. Weinstein MC, Siegel JE, Gold MR, Kamlet MS, Russell LB. Recommendations of the Panel on Cost-effectiveness in Health and Medicine. JAMA. 1996;276:1253-8. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: University of Pennsylvania School of Medicine; Philadelphia, PA, USA 19104 (Lewis)Corresponding Author: James D. Lewis, MD, MSCE, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, 9th Floor, Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104-6021; e-mail, [email protected]med.upenn.edu. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCost-Effectiveness of Colonoscopy in Screening for Colorectal Cancer Amnon Sonnenberg , Fabiola Delcò , and John M. Inadomi Cost-Effectiveness of Screening for Colorectal Cancer Mark K. 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Scheiman, MD, Michael E. Chernew, PhD, and A. Mark Fendrick, MDCost-Effectiveness of Screening for Colorectal CancerMark K. Chelmowski, MD 17 October 2000Volume 133, Issue 8Page: 647-649KeywordsCancer preventionColonoscopyColorectal cancerFlexible sigmoidoscopyHealth careHematologic testsMedicareMortalitySpecificitySurvival analysis ePublished: 17 October 2000 Issue Published: 17 October 2000 Copyright & PermissionsCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...