How much does a colonoscopy typically cost? My insurance deductible is high ($4,600). I'm 47 and my father died of colon cancer at age 80.

Tom

Colonoscopy is a procedure in which doctors examine the inside of the colon using an endoscope -- an instrument consisting of a tiny video camera attached to the end of a flexible tube. The cost of colonoscopy depends on several factors, including the part of the country where you live, your insurance plan, the doctor performing the procedure and the setting in which the exam is done (hospital, outpatient endoscopy center). The cost has come down dramatically in the last five years, mainly in urban areas where HMOs and other managed-care plans have a strong presence. The typical cost range is $500 to $1,000 (assuming your insurance will not cover the exam or you have not met your deductible).

Keep in mind that colonoscopy is the most accurate way to screen for colon cancer because it enables doctors to detect colon polyps. Detection and removal of polyps is crucial to preventing colon cancer because we know that, in the vast majority of cases, this cancer begins in a polyp. While not all polyps will become cancerous, we currently have no way of predicting which polyps will eventually grow into cancerous ones. It is known that polyps tend to develop more rapidly in older people. Thus, for most people, colonoscopy screening is recommended starting at age 50.

For someone with a family history of colon cancer, colonoscopy is recommended starting at an age that is 10 years younger than the age at which the family member was diagnosed, or at age 50 -- whichever is younger. Although you do not state how old your father was when he was diagnosed, if it was after age 60, you should be screened starting at age 50. Anyone who needs a colonoscopy but who cannot afford one should discuss the issue with a doctor to see what options might be available.