Costs and effectiveness of colorectal cancer screening in the elderly

Article Abstract:

A report issued by the Congressional Office of Technology Assessment (OTA) and titled "Costs and Effectiveness of Colorectal Cancer Screening in the Elderly" is summarized. The report is to be used to help determine whether Medicare should pay for such screening. Colorectal cancer (CRC) is mainly a disease of older people: a person who is 65 years old has six chances out of 100 of developing this disease. Testing for CRC with either flexible fiberoptic sigmoidoscopy (FSIG, where a flexible fiberoptics tube is used to examine the rectum and colon) or the fecal occult blood test (FOBT, a laboratory analysis of stool specimens to detect the presence of blood) is recommended by several cancer associations. However, no well-controlled studies have shown that either method reduces mortality from CRC. No differences between screened and control subjects in mortality or cancer incidence have been found. Estimates of the cost-effectiveness of CRC screening were compared with estimates for other preventive services that Medicare already pays for, to evaluate whether CRC screening is sufficiently cost-effective. This approach has been criticized on the grounds that results of screening trials should be included in OTA's evaluation. The response of OTA is that indirect evidence for the lack of cost-effectiveness of CRC screening already exists, and that research results concerning FOBT are not likely to resolve the issue. Different results from different studies could generate debate that would last for years. Moreover, screening is expensive. Perhaps the most memorable observation in the OTA report is that ''Preventing cancer or finding it early does save some cancer treatment costs, but these are minuscule compared with the direct and induced costs of screening.'' (Consumer Summary produced by Reliance Medical Information, Inc.)

Finance, Diagnosis, Colorectal cancer, Social policy, Surveys, Medical screening, Health screening, Medicare, Cost (Economics), Costs (Economics)

---

Forensic uses of DNA tests

Article Abstract:

Evaluation of DNA (genetic material), which is unique for each person, can be performed to determine whether two samples (of blood, for instance) are identical and, in criminal investigations, the likelihood that a particular person was associated with a crime. The use of DNA typing in forensic work has escalated, along with concern about possible infringements of defendants' civil liberties. A summary of a report from the Congressional Office of Technology Assessment (OTA) on forensic use of DNA is presented. The report found that DNA tests are valid (that they accurately portray reality), but they do not provide positive identification. While they narrow the field of possible suspects, a field (albeit a very small one) still remains. The tests are generally reliable (reproducible), but whether any single test is reliable is open to question. The development of quality-assurance standards regarding test procedures is essential; presently, the field of DNA testing for criminal justice is not regulated. This is true in spite of the fact that DNA profiling has been used in cases in 49 states, the District of Columbia, and the military. Proposals to create state and national databases of DNA profiles have been opposed on social and technical grounds. Fears of abuse of privacy and concern that technological changes will make any database quickly obsolete are at issue. Forensic use of DNA tests not only condemns defendants, however; 37 percent of 500 rape and homicide investigations by the FBI that used this method were ultimately resolved in favor of the primary suspect. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Laws, regulations and rules, Testing, Identification and classification, Criminals, Forensic DNA testing, Forensic genetics

---

Similar abstracts:

• Abstracts: Cytologic detection of colorectal cancer after administration of oral lavage solution
• Abstracts: Changes in the prescription patterns of psychotropic drugs for cancer patients during a 10-year period. Epidemiologic perspectives on life-style modification and health promotion in cancer research
• Abstracts: Unions: their role in health and safety issues. An example of health-care provider intervention in the workplace
• Abstracts: Cervical cancer screening in elderly women. Emergency medical care and the public purse
• Abstracts: Incidence of campylobacteriosis among patients with AIDS in Los Angeles County

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.