There are about 100,000 new cases of colon, plus 40,000 rectal, cancers per year in the US. The incidence has declined by 2-3% per year over the past 15-20 years. Due at least in part to plucking out lots of small polyps at lots and lots of colonoscopies!

I agree that it’s a terrible conundrum to try to measure lives in dollars, and somewhat offensive (at least to me), but when we’re talking about reimbursement for procedures (especially when it’s government programs making the decision about whether or not to fund a medical intervention), it seems to become inevitable.

I also think that there are a lot more unknowns in medicine than most people suppose. For example, it’s probably unknown what percentage of suspicious polyps would go on to become cancerous if left alone—or is it?

A cancerous polyp is not a polyp; it is a cancer, possibly not yet invasive, but still a cancer.

I did not read your link because my computer is having fits of lethargy. But the cost per yr of life saved kinda depends on the reimbursement method (MCare vs Non-MCare) and it kinda depends on what a year of life is worth, e.g. at 60, vs 70. Cost per yr life saved is a convenient but curious metric. One person does not gain a year, or X years, by having colon cancer prevented. I am not intellectually or emotionally equipped to speak to that, and never have been. A life is a life, in my book. I don’t manage populations; that is a task for the unfeeling, like Sibelius.

Dunno if this answers you in any way!

So, wouldn’t colonoscopies be considered treatment sometimes (in some percentage of cases; I don’t know how often such polyps are found), and wouldn’t that have to be compared to the cost of treatment of the same cancer at a much later date (that is, the cost of chemo and/or radiation and/or a big surgery and/or ostomy care if necessary, and/or death?)

By the way, I found this study and this finding:

Compared with no screening, the incremental
cost-effectiveness ratio of a single or repeated colonoscopy
amounts to $2981 or to $10983 per life year saved,
respectively. A single colonoscopy saves most life years
if done at the age of 60, but becomes most cost-effective
after the age of 70. Depending on the level of compliance,
repeated colonoscopies save 2 to 3 times more lives
than a screening program based on a single colonoscopy

As to the profit motive by MDs, please be aware that diabetics do not get insulin/test strips from MDs, but from pharmacies. Docs in increasing #s are refusing to see MCare and MAid patients because it flat ain’t worth their time: it is not that they do not earn enough from them; they lose money. It costs them more to see these patients than they are paid.

Sorry for having to explain the obvious.

AFAIK it’s incurable but often misdiagnosed (iow elevated blood sugar levels and/or swinging insulin levels are automatically diagnosed as diabetes even if they are not always diabetes by far), and if something else (or “proto-diabetes”, iow the symptoms could become diabetes but haven’t yet) it can be handled and they disappear.
It’s so simple nowadays for doctors to make a life changing diagnosis that will put you up for a lifetime of expensive doctor’s visits and medication, a highly lucrative prospect for them.
So they may well never look beyond those diagnoses (and what’s less lucrative for a doctor than to get someone diagnosed with diabetes, he’ll have to be back several times a month for life to buy more insulin and test strips?).
Not saying it’s (always) malice, but it’s also an easy way out.
With governments constantly putting out scare stories about “diabetes epidemic”, “cancer epidemic”, “obesity epidemic”, etc. etc. patients expect to have all that, to see it diagnosed (and I’d not be surprised if they’re pushed to diagnose it by regulators as well as by drug companies offering nice incentives and kickbacks for drugs sold, which they do) is almost a relief.

“Surveillance colonoscopy cost Medicare about the same as ALL radiation therapy when last I looked (some yrs ago).”

Maybe. But per patient? If there’s a million colonoscopies performed each year and 10.000 radiation therapies (e.g.), radiation therapy can per patient cost 100 times as much as a colonoscopy and still not be more expensive as a total figure in Medicare’s annual reports.

““Preventative” care costs every time, and in terms of detecting things like diabetes and hypertension early, there is No Cure. ”

If caught early (in “proto” stages, so to speak) these can often be kicked in the nuts before turning into the full blown (and indeed incurable) condition, improving lives and saving cost in the long run. See above as to why this isn’t done more often.

And even know when the whole European experiment is collapsing we still have people who think it’s the best thing since sliced bread.

And all you have to do is convince someone that he other guys stuff should be theirs and then promise to take it away from that other guy and give it to them.

And interesting conversations like the one here about treatment choices? They don’t have them. The proles get what their given and die when they’re supposed to.

What’s not to like?

What could go wrong?

Gentlemen, I have learned a lot from listening to you here. My husband is 44 and has just started getting PSA tests during his “executive physicals” (which he hates but which are required in his position). One of his high school friends was among the people who worked on the development of the PSA test, so it’s never occurred to the hubby to question whether to GET the test; I’ll be talking with both the hubby and the friend about it, now that I’m better informed.