A good example of recaf's potential is H.N.P.C.C., an inherited condition in which the person has an extremely high likelihood of getting colon cancer (at a young age), and a higher than average likelihood for a number of other cancers.

Those patients, at a minimum, should get an annual colonoscopy beginning in early adulthood (cost for the uninsured between $2000 and $4000 last I saw). The rationale for annual colonoscopy pertains to not just the increased likelihood of colon cancer, but also a more rapid onset of malignancy and metastasis than the general population. If a regular test like recaf could reduce the frequency of colonoscopy even to once every 18 months, it would be a huge financial benefit. Regardless, some people following this annual scoping regime still get metastatic colorectal cancer and die.

Virtual colonoscopy is intriguing and cheaper, but it is not foolproof. I also don't think it is recommended for followup after surgery. (better at detecting polyps but not mets?)

Perhaps someone more knowledgeable can comment on this, but it seems to me that the virtual approach uses CAT technology which gives you a very high dose of radiation relative to an X-ray. This wouldn't be an issue for an elderly person getting a few, but I understand that there is a long term concern about leukemia from excessive CAT scans...which is exactly what an hnpcc patient would be going through if they got annual virtual colonoscopies beginning in their 20's.

I have also commented in a previous post about how much oncologists rely on CEA for colon cancer followup for 5 years as well as for deciding on adjuvant therapy for stages II and III which are often unnecessary...they just can't tell because of the unreliability of CEA.

Stage I colon cancer is curable by surgery over 90% of the time; stage IV typically incurable. In other words, early detection (RECAF and colonoscopy???) and surgery are key.