Screening for colon cancer (or colorectal cancer, bowel cancer)

[RetMD21]

Once you have any "history" of colon trouble, everything from there out is going to be diagnostic, even if you don't have symptoms and you're just coming back in 5 years, or whatever.

Not generally true based on
1. The links
2. My experience

Insurance companies may differ but Medicare allows screening every 2 years for high risk.

 

[Dtail]

I don't think screening colonoscopies have been treated the same over the years.

There was a time when a screening colonoscopy was later flipped to a diagnostic colonoscopy if a polyp was discovered, but I think they changed that rule so that if you go in as a screening, it stays a screening, no matter what they find.

Once you have any "history" of colon trouble, everything from there out is going to be diagnostic, even if you don't have symptoms and you're just coming back in 5 years, or whatever.

I was told the same thing, but ended up not having to pay for mine.

 

[JoeWras]

First: I want to report that one of my SIL's is in her final days due to colon cancer. She not only didn't want to get screened (colonoscopy), but she also avoided the doctor for months once symptoms appeared. Despite her husband's pleas, she waited until she was too weak to walk. By then, it is over. Metastases all over. Her time after diagnosis will be 1 to 3 weeks as she is refusing any treatment except pain management. I hate to say it, but she is essentially dying a death by natural suicide. She's headstrong and has her own ideas. It is really a mystery to the rest of the family.

Don't mess with colon cancer.

Second: I appreciate this thread. I was lucky to get a warning by seeing about 100 ccs of blood after a movement. This was after explaining away the occasional 1 cc or so for years! I always had an excuse: hemorrhoids, red jello, etc. It is very simple, ANY red or blood in the stool should be an immediate doctor appointment.

After GI doc saw very little hemorrhoids, he called for a colonoscopy and found multiple polyps. I was lucky to have such a bleeder before it turned cancerous.

So, my schedule for colonoscopies is: 2013-2014-2017-2022. I'm due! In my past 3, I was never charged. We changed insurance in the last 5 years, and rules have changed. I wonder if I'll be charged in my 5 year follow up this summer?

 

[skyking1]

I hope not Joe. My 50-year-old niece passed away during the height of the COVID in May 2020.
Her little sister had it too and has recovered. To say that it's serious is an understatement.

 

[Helen]

I'm so sorry for those who have lost or are losing a loved one to colon cancer.

I have had three colonoscopies and they have found polyps every time. I consider a colonoscopy my most important health screening. I'm scheduled to have a genetic (blood) test for colon cancer later this year.

 

[JoeWras]

I hope not Joe. My 50-year-old niece passed away during the height of the COVID in May 2020.
Her little sister had it too and has recovered. To say that it's serious is an understatement.

Oh, so sorry skyking. 40 is the new 50 for screening in my book. I think some insurance covers it down to 45 now.

I will still get the test whether my insurance covers it or not.

 

[tulak]

Oh, so sorry skyking. 40 is the new 50 for screening in my book. I think some insurance covers it down to 45 now.

I will still get the test whether my insurance covers it or not.

I should have had mine at 42, because my dad died of colon cancer at 52. I did not know his cause of death - beyond cancer - and didn’t find out specifics until last year.

When I was in for my colonoscopy, the doctor said it is 10 years prior of death of family member (52-10=42 in my case). Otherwise 45 if you have family history.

 

[Turbo29]

I had my first colonoscopy in 2007 -- 2 polyps, so they put me on the 5 year plan. In 2012, no polyps and again in 2017 no polyps. In 2017 the gastroenterologist said that because I had been without polyps for two visits I was going back on the 10yr plan (no colonoscopy until 2027).

I find the long interval a bit unsettling.

 

[Aerides]

I find the long interval a bit unsettling.

I would agree, and maybe say, nah, keep me on 5, or find another gastro doc. Ours is a bit younger than us (late 40's maybe?). I distinctly remember him meeting with DH after one of his a few years ago, and he revealed to us that his father and grandfather had both died of colon cancer, so he gets one every single year as he refuses to follow their fate.

One of the benefits of hopefully having a bit of discretionary money, is throwing it at health expenses, even if not covered or included.

 

[braumeister]

My doc sets his own schedule. First one found polyps, second scheduled for seven years later. Polyps again, so next was six years. None found that time, so eight years for the next one. Polyps again, so five years this time.

 

[Montecfo]

I had my first colonoscopy in 2007 -- 2 polyps, so they put me on the 5 year plan. In 2012, no polyps and again in 2017 no polyps. In 2017 the gastroenterologist said that because I had been without polyps for two visits I was going back on the 10yr plan (no colonoscopy until 2027).

I find the long interval a bit unsettling.

My internist used to say something like 85 percent of polyps are found on initial colonoscopies.

Another way if saying that they are rarely found on subsequent ones.

 

[harllee]

My internist used to say something like 85 percent of polyps are found on initial colonoscopies.

Another way if saying that they are rarely found on subsequent ones.

But there are some people (like my DH) who have polyps every time (he gets a colonoscopy every 5 years). DH has had 5 colonoscopies and has had polyps every time.

 

[sengsational]

Not generally true based on
1. The links
2. My experience

Insurance companies may differ but Medicare allows screening every 2 years for high risk.

I was told the same thing, but ended up not having to pay for mine.

Thanks for the good news (about how just because your previous colonoscopy included polyps, that doesn't mean you can't get your next one coded as a screening). I'll keep that in mind.

It would seem to me that doctors would try to code things to ease the financial burden on the patient, but in my experience, they make it as painful as possible I've always wondered if the compensation ends-up to be different for diagnostic vs screening. They apparently do the same work, but maybe they're expected to spend more time or have extra stuff done on a diagnostic that they can't get away with on a screening.

 

[Helen]

But there are some people (like my DH) who have polyps every time (he gets a colonoscopy every 5 years). DH has had 5 colonoscopies and has had polyps every time.

Your husband and I are in that 15% group. My first colonoscopy found 13 polyps, then 4 years later 3, then 3 years later 8. I haven't eaten red meat or chicken since 1976 so it isn't that.

I didn't know the appendix was at the end of the colon. They found a polyp in my appendix and said they couldn't see far enough into the appendix to know if they got it all so I opted to have the appendix yanked. It was worth it for the peace of mind.

 

[JoeWras]

Thanks for the good news (about how just because your previous colonoscopy included polyps, that doesn't mean you can't get your next one coded as a screening). I'll keep that in mind.

It would seem to me that doctors would try to code things to ease the financial burden on the patient, but in my experience, they make it as painful as possible I've always wondered if the compensation ends-up to be different for diagnostic vs screening. They apparently do the same work, but maybe they're expected to spend more time or have extra stuff done on a diagnostic that they can't get away with on a screening.

This was something that my GI office seemed to really have a good handle on. They did a lot of legwork up front and assured me what my costs would be ($0), because they pre-approved it with insurance for the 2nd and 3rd test. I was especially concerned about the extra charge for yanking polyps and biopsy, but there was no issue. And finally, having an anesthesia professional present is another cost they assured me would be covered.

Now it has been 5 years so who knows if the office changed or the insurance changed. We shall see in a few months.

 

[Teacher Terry]

Joe, that’s so sad about your SIL. It’s strange that once she had symptoms that she didn’t quickly go to the doctor when treatment was still possible. Personally the dilemma for me about how often to get screened is the risk of lining perforation which often leads to death. It’s funny how people are different because my sister sees no risk and is trying to find a doctor to do one since she is 76. She has had polyps every time but the last one.

 

[Fermion]

Just got done with my age 50 (51) colonoscopy. So clean there were not even any polyps to remove.

The part that was interesting to me was the anesthesia. I was concentrating really hard to detect when I would get drowsy from the IV and the next second I swear they were wheeling me back into the recovery room saying we are done.

I now no longer doubt those movies where they shoot a guy with a dart and he falls over instantly.

 

[RetireAge50]

Just got done with my age 50 (51) colonoscopy. So clean there were not even any polyps to remove.

The part that was interesting to me was the anesthesia. I was concentrating really hard to detect when I would get drowsy from the IV and the next second I swear they were wheeling me back into the recovery room saying we are done.

I now no longer doubt those movies where they shoot a guy with a dart and he falls over instantly.

Funny. Same experience here 5 years ago. Clean and no memory of the procedure. Perfect.

 

[Ian S]

Just got done with my age 50 (51) colonoscopy. So clean there were not even any polyps to remove.

The part that was interesting to me was the anesthesia. I was concentrating really hard to detect when I would get drowsy from the IV and the next second I swear they were wheeling me back into the recovery room saying we are done.

I now no longer doubt those movies where they shoot a guy with a dart and he falls over instantly.

Almost certainly propofol was used. Although it can be used for sedation, my experience with its use for colonoscopies and endoscopies mirrors yours: very quick knockout and then coming to in the recovery room with no memory of what transpired in between. Safety requires constant monitoring of vitals and control of the amount going into your IV.

 

[JoeWras]

Propofol: dream away. No wonder Micheal Jackson got addicted to it.

 

[Freedom56]

I had mine done at age 50 (no polyps) but was in a semi sedated state with fentanyl. It was like an alien abduction complete with probes. Time passed very quickly. I just do an annual stool blood and DNA test now and if I get a positive result the aliens will come for me again.

 

[athena53]

Propofol: dream away. No wonder Michael Jackson got addicted to it.

I know. I've had it for dental implants and I go in knowing that I'll drop off in mid-conversation and wake up when it's over. Magic stuff.

DS is 37 and given my history (and parents' history) of polyps and DDIL's father's recent death from colon cancer, I'm hoping to persuade them to start early with the fecal occult blood test even if they have to self-pay. It's not as specific as Cologuard or the full colonoscopy but it's an indication and that's what prompted me to get the first colonoscopy after the result was positive. You can buy them on-line and they're under $100.

 

[Rianne]

I'm waiting for the results of my 3rd Cologuard test. No colon cancer in the family and no issues that I know of, so this was the screening of choice. I get a test every three years.

 

[MarieIG]

Had my first colonoscopy at 44; and my most recent (overdue) colonoscopy in February. The doctor would not order Cologuard for me as I am high risk. I lost DM from colon cancer, and as one of the prior posters noted, the pain was excruciating.