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The news from Sloan-Kettering Cancer Center that colonoscopy measurably saves lives will certainly make me feel better when I start drinking the liquid the night before mine. But really, what my doctors have been telling me from their own experience is why, as much as I hate doing it, I'm pretty religious about the timetable.

When I say I hate doing it, I don't mean the night-before business, about which even doctors try to reassure you. What bothers me is not the discomfort. Any woman who has ever had a child, or watched, knows that discomfort is not a reason not to do something worth doing. It's the fear: the moment before the doctor tells you the baby looks great, the screen is clear, no cancer was detected.

Earlier this week, I had my regular mammogram, and the wonderful tech, a woman named Gloria at Cedars-Sinai, asked me over and over again during the compression whether she was hurting me. I laughed. "Do women really complain about this?" She rolled her eyes. Ridiculous. Of course it hurts, but so what? We're talking about saving lives, ladies.

Katie Couric has done more than anyone to promote colonoscopy -- and yet still smart people don't always listen. I just learned that an old friend, a wonderful woman who is smart, sensible and, yes, amply insured, is suffering from untreatable colon cancer, has used up all options and is at home with 2 4/7 care. I asked our mutual friend whether she'd had a colonoscopy. Nope. Well into her 60s and she never had one. Why? Because she'd heard it was unpleasant, because she didn't have time, because she was too busy taking care of everyone else to take care of herself, because she trusted in fate. It doesn't matter. There is no good answer.

When I speak at graduations, I always tell the students that it's not the hand you're dealt but how you play it; how you adapt to what you cannot change. Some hands are better than others. Having parents who live to see their 90s is a good hand. Having a father die at 54, which is what happened to mine, is less good. But he smoked and drank, and he didn't exercise, and he didn't take his blood pressure medicine, which doesn't mean he deserved to die, but it should be a red flag for his children.

The older you get the clearer it is that you can do everything right -- get the tests and the checkups, eat the right foods, take the right vitamins, work out and meditate and the rest -- and it won't necessarily save you. Most of the oldest people I know tell me that luck matters. Of course it does. But counting on luck is pure foolishness.

There are no guarantees, but regardless of your hand, there are better and worse ways to play it. We need a system in which everyone has access to health care so that all Americans have the chance to play their hands well. But having access is no guarantee. I have too many sad stories that prove it.

For adults to avoid a colonoscopy because they can't face a night in the toilet is sheer foolishness. To skip a mammogram because you don't like having your breasts squeezed between two plates is just silly. It's easy to start smoking when you're young and stupid; it's hard to stop smoking when you're older and addicted. Believe me, I know. I tried eight times before I finally succeeded in quitting at 33, and I still wince every time I get a chest X-ray. But we all do hard things in life. We face days so much more difficult than one without a cigarette, or than a night spent in the toilet or an afternoon with your breasts squeezed between two plates.

Get a good book, and get a colonoscopy. I'm told you only have to drink half as much liquid as you used to. Take care.