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January 24/31, 2001

Cost-effectiveness of Colorectal Cancer Screening—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor

JAMA. 2001;285(4):407-408. doi:10.1001/jama.285.4.407

In Reply: Drs Budenholzer and Welch assert that discussions about the cost-effectiveness of colorectal cancer screening may be premature in light of the insufficient evidence about the effectiveness of colonoscopy. We agree that the ideal evidence would be from randomized clinical trials. However, a screening trial of the general population would require a fairly large sample size and long time horizon. Even with a large anticipated risk reduction, the baseline incidence of colorectal cancer is relatively small.