A little more Canada bashing

A little more Canada bashing

Looks like someone hasn’t followed through on the cost-benefit equation here. From the Montreal Gazette:

Quebecers hoping to be screened for colon cancer are facing up to a year-long wait for diagnostic tests that could save their lives…

[E]xperts suggest that colonoscopy screening could prevent up to 90 per cent of colon cancers. That’s because polyps that could develop into cancer are removed during the scope.

Canada spends about $500 million a year treating colorectal cancer, [Professor of Medicine William] Paterson said. Surgery can be arranged within weeks of a cancer diagnosis, he said.

“Treatment is not a problem. But that patient may have waited a year to get a colonoscopy and maybe they wouldn’t have had to have the surgery if they’d had access to a colonoscopy at the appropriate time,” Paterson said.

But not everyone agrees that emphasis should be placed on improving the screening rate:

Paul Brunet, director of the provincial patients’ rights committee, questioned the benefits of colon cancer screening when “it’s more urgent to give people treatment once they get the diagnosis. Because even then there are delays.”

Here’s a suggestion for you non-aggressive Canadian types. If the guideline is to get a colonoscopy when you turn 50, request one at 49 instead.

June 29, 2006

4 thoughts on “A little more Canada bashing”

  1. “If the guideline is to get a colonoscopy when you turn 50, request one at 49 instead.”

    ROTFLMAO

    Seriously, though, it looks like the Canadians have the exact same problem we do. Their system rewards treatment of acute episodes of ill health rather than wellness and prevention.

    How do you say “that’s just dumb” in French?

  2. Well as far as screening goes, I don’t see a problem with scheduling one year in advance – everyone knows when they are going to turn 50. Also colorectal cancer is slow-growing, so there unlikely to be a huge difference between 1st at 51 and next at 61 as opposed to 50 and 60. If somebody has to wait for diagnostic colonoscopy e.g. after a positive FOBT or an episode of bleeding it is more of a problem.

    Seriously, though, it looks like the Canadians have the exact same problem we do. Their system rewards treatment of acute episodes of ill health rather than wellness and prevention.
    Do you know the NNT for most preventive tests/drugs? Check it out. For the most screening tests it is in the thousands and that after 10 years of screening. So the effect on individual’s health is very small. No, I am not arguing against tests – you can certainly be this 1 in 1000 who benefits, but people need to understand how small the probability of you personally benefiting really is. Also there are always risks – like a risk of perforation during colonoscopy or even
    kidney failure
    . The probability of it is small, but the probability of you personally benefitting is also small. I’d personally would love to see both numbers – the probability of a cancer in a 50-year old be prevented vs probability of perforation. No meaningless relative number or total number of people who get this cancer or lifetime risk. A 10-year risk of a 50 year old, probability that colonoscopy prevents this cancer (also compared to other methods) vs probability of perforation or other bad effects. If anybody has these numbers, I’d love them.

    The only two preventive measures that have really big effect on health are non-smoking and treating (better yet avoiding) diabetes.

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