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Health-conscious boomers request screening once widely avoided

Posted: Friday, January 23, 2004

NEW YORK (AP) Michele St. Martin, still in her mid-40s and without a family history of illness, seemed an unlikely candidate for worry.

But after watching a television program about the risks of colon cancer a few years ago, St. Martin somewhat sheepishly raised the subject with her doctor and obtained permission to undergo a thorough screening, known as a colonoscopy.

The physician ''probably thought I was a little wacky,'' says St. Martin, who is 46 and lives in Willmar, Minn. ''But at the small hospital I went to they said they were doing eight of them (colonoscopies) that day.''

It turns out St. Martin's pursuit of a colonoscopy was far from unique.

Interest in colonoscopies in which a physician uses a long, flexible scope to inspect a patient's large intestine has soared in the past few years, with baby boomers driving much of the demand. That is a sharp contrast with the past, when many physicians had to persuade patients to undergo a procedure that had a reputation for discomfort and embarrassment.

The surge has stretched out waiting times for screenings, and prompted some practices to increase the number of doctors and space devoted to the procedure.

Doctors say several unique factors fueled interest in the procedure, which is recommended for most adults once they turn 50. But they say it also reflects the health-consciousness of baby boomers those born between 1946 and 1964 who are showing greater interest than their parents' generation in many types of medical screening from tests for cholesterol levels to mammographies.

''We're a very educated generation,'' said Dr. Juan Nogueras, a colon and rectal surgeon in Weston, Fla., who is 47. ''We're the first generation to go into the delivery room when our kids were born. We're very aware of health maintenance and disease prevention. ... So it's no surprise that the baby boomers are very interested in all sorts of screening.''

Physicians credit much of the interest in colonoscopies to television personality Katie Couric, who launched an awareness campaign after her husband died of colon cancer at 42. In 2000, Couric underwent a live colonoscopy on the Today Show.

Almost immediately, doctors say, queries about the disease surged, particularly among women in their 40s.

A study published last year by a group of University of Michigan researchers in the journal Archives of Internal Medicine found that colonoscopies performed by a group of 400 doctors and a separate group of physicians under the umbrella of an HMO jumped 20 percent in the months after the Couric campaign and was continuing to rise.

Doctors also credit the interest to a decision by Medicare to cover the cost of colonoscopy for patients over 50. Most Medicare recipients are over 65, but many private insurance companies have followed its guidelines and expanded their own coverage, physicians say.

Medical practices specializing in gastroenterology used to routinely compete for patients, but the increased demand has flipped the equation, said Dr. Stephen Bickston, an associate professor of medicine at the University of Virginia, who performs colonoscopies.

''What they do now is compete for partners. They want young a guy just out of training to come join them,'' Bickston said.

The university's practice performed 6,000 screen examinations for colon cancer last year, nearly all of them colonoscopies. That is up from about 1,000 exams performed in 1995, when nearly all the procedures done were sigmoidoscopies, which looks at just a portion of the large intestine.

The increased demand at one point stretched the scheduling time for colonoscopies at the hospital to two months. So a year ago, the practice expanded to an ambulatory surgery center a few blocks away, which had an extra room.

The Cleveland Clinic Florida, where Nogueras is chair of the surgery division, also has seen demand for colonoscopies pick up. So last year it hired two new physicians to perform them, increasing the ranks from 8 to 10.

Boomers who have requested the procedure say it was a carefully measured decision rather than a matter of following the pack.

David Shank, 54, of Indianapolis, had been experiencing some discomfort, but even after he turned 50, put off getting the screening. But Couric's campaign, and resulting jokes on the subject by late-night television hosts, pushed him to think about it.

''It took me a couple of years to get up the nerve to do it,'' Shank said. ''As it turned out, it was not that big a deal.''

St. Martin, whose screening detected inflammation but not cancer, was so convinced of the procedure's value that she also pushed her husband to undergo the procedure. Since then, she's also urged her parents to have colonoscopies, and talked the subject over with friends and other relatives.

''I think there's a lot of awareness,'' she says. ''It's not an obscure topic, that's for sure.''

On The Net:

American Society of Colon & Rectal Surgeons: www.fascrs.org



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