One Complication of the Couric Crusade
by Gary Schwitzer
NBC Today Show co-host Katie Couric's live, on-air colonoscopy, and
followup campaign for colon cancer screening reached thousands of Americans.
Couric started her campaign after her husband died of colon cancer
at the age of 42.
University of Michigan researchers analyzed the colonoscopy rates among
hundreds of doctors who perform the procedure.
They compared the rates 89 weeks before the on-air campaign and 40 weeks
after. The number of colonoscopies
increased by almost 20 percent.
One other finding was that the average age of people having colonoscopies
decreased significantly. That is the
point that is troubling about the Couric campaign. She used her position as the co-host of a national television
show to publicize her own choice to have a colonoscopy---even though there is
no evidence-based guideline to support colonoscopy in an otherwise healthy
woman in her forties. Her husband's
death from colon cancer had nothing to do with her risk. If her campaign resulted in people younger
than age 50 pursuing colonoscopies, that might not be a good thing. The United States Preventive Services Task
Force recommendation reads, in part: "Screening
for colorectal cancer is recommended for all persons aged 50 and older with
annual fecal occult blood testing (FOBT), or sigmoidoscopy, or both. There is
also insufficient evidence to recommend for or against routine screening with
digital rectal examination, barium enema, or colonoscopy."
A study in the June 6, 2002 New England Journal of Medicine,
"Results of Screening Colonoscopy among Persons 40 to 49 Years of
Age," concludes:
"Colonoscopic detection of colorectal cancer
is uncommon in asymptomatic persons 40 to 49 years of age. ... If these results are applicable to the
general population, at least 250 persons, and perhaps 1000 or more, would need
to be screened to detect one cancer in this age group."
There is no question that colon cancer is a leading killer. There is no question that Couric reached many
people with her campaign. But there
is also no question that screening campaigns should be based on evidence,
not on emotion.