As both colonoscopy rates and use of anesthesia during gastrointestinal endoscopies are projected to increase in the coming years, the overall cost of colonoscopy screening programs will be closely scrutinized by payers and policy makers. Liu, Waxman, Main and Mattke made the quoted prediction in their article Utilization of Anesthesia Services During Outpatient Endoscopies and Colonoscopies and Associated Spending in 2003-2009 (JAMA. 2012;307(11):1178-1184).  This study involved a retrospective analysis of claims data for a 5% representative sample of Medicare fee-for-service patients (1.1 million adults) and a sample of 5.5 million commercially insured patients during the six year period 2003-2009.  The authors determined that overall, the proportion of anesthesia services delivered to low-risk (ASA physical status 1 or 2) patients was more than two-thirds in the Medicare population, and more than three-quarters among the commercially insured population.  Over the six-year period, annual payments for anesthesia services among Medicare patients almost doubled in...