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

[RetiredHappy]

Cologuard claims to detect about 50% of polyps.

 

[harllee]

Cologuard claims to detect about 50% of polyps.

On the other hand a colonoscopy detects over 90% of polyps. Why would anyone risk their lives on cologuard?

 

[Montecfo]

Rodi,

I'm saddened for your loss! Certainly a cautionary story.

On your personal experience my internist used to tell me that 85 percent of polyps are found on initial colonospies.

So first one being clean is good sign. Can ease nerves on subsequent ones.

Family history does play a role in frequency guidance.

All the best.

 

[Montecfo]

You're not the only one confused. It's our lovely medical system doing what it does best: obfuscation about costs.

Mine was timestamped. From cecum to "the end" was 7 minutes and 39 seconds.

So were there stock photos on your report? How much time is the correct amount in your opinion?

 

[RetiredHappy]

On the other hand a colonoscopy detects over 90% of polyps. Why would anyone risk their lives on cologuard?

Very simply... my best friend's mother died after her colon got perforated during a colonoscopy. Another very close friend has a clip permanently inserted into his colon after a botched colonoscopy and he almost died. Another person had a ruptured spleen from a colonoscopy and similarly had to be operated on.

 

[Montecfo]

Very simply... my best friend's mother died after her colon got perforated during a colonoscopy. Another very close friend has a clip permanently inserted into his colon after a botched colonoscopy and he almost died. Another person had a ruptured spleen from a colonoscopy and similarly had to be operated on.

A tragedy for sure. But statistically isn't this a bit like not wearing a seatbelt because your cousin got "thrown clear" of the car and survived a crash not wearing one?

 

[RetiredHappy]

A tragedy for sure. But statistically isn't this a bit like not wearing a seatbelt because your cousin got "thrown clear" of the car and survived a crash not wearing one?

On the contrary. Your analogy is for someone who had not gotten screened and say, hey see I don't need screening and I have not died from colon cancer.

These are close friends of mine who had botched procedures. Our pool guy (owner) 's uncle is some big shot doctor at Cleveland Medical Center. Our pool guy said his uncle told him that the risk of colonoscopy going wrong is much higher than most people realize and he has never had a colonoscopy done himself. His advice to our pool guy is to have Cologuard every year. If insurance does not pay for it yearly, then just pay out of pocket. Remember that colonoscopy is used as a screening option and a polyp removal procedure. For people with regular colon cancer risk, there are 2 other screening options which are non-invasive. We make our own health care decisions.

 

[harllee]

Almost all my friends have colonoscopies at recommended intervals (and I would guess that at least half have polyps removed) and I have never heard of anyone that has had a botched colonoscopy. I would think that a botched colonoscopy is very very rare. On the other hand a colonoscopy that finds a polyp is very common. Yes we all have to make our health care decisions. I hope that folks reading this thread get some sort of colon screening and if it were me I would definitely get a colonoscopy.

 

[daylatedollarshort]

Interesting study, but my guess is that swapping the traditional Western Diet with just about ANY diet that is lower in processed junk foods would have achieved a similar result. Here is the Western Diet as they described it:

"people in South Africa ate an “American” high-fat, low-fiber diet: Foods included beef sausage links and pancakes for breakfast; hamburger and French fries for lunch; and meatloaf and rice for dinner."

This diet is high in ultra-processed grains (pancakes, burger buns); industrial seed oils (french fries); and sausage links are a processed meat product. And my guess is that the condiments on the burgers contained some unhealthy ingredients as well, like soybean oil. Ketchup on the fries contains high fructose corn syrup. Maple syrup (probably fake) on the pancakes would contain lots of either sugar and/or high fructose corn syrup. Replacing those things with just about ANY unprocessed, whole foods would certainly improve the diet, and probably reduce the risk for colon cancer. So I don't necessarily think the takeaway message from this study should be that Americans should eat less fatty foods, or that we should eat exactly like Africans do. What we should be doing is replacing unhealthy fats (industrial seed oils) with healthy fats, and seeking out whole foods (vegetables, even baked potatoes, fish, grass-fed meat) rather than junk foods such as french fries and processed meat products.

Your reply got me interested in seeing if there were other studies like this. I found this one: Rarity of colon cancer in Africans is associated with low animal product consumption, not fiber - PubMed (nih.gov),

"The low prevalence of colon cancer in black Africans cannot be explained by dietary "protective" factors, such as, fiber, calcium, vitamins A, C and folic acid, but may be influenced by the absence of "aggressive" factors, such as excess animal protein and fat, and by differences in colonic bacterial fermentation."

The nutritionfacts site says colon canceris extremely rare in native African populations, more than 50 times lower than rates of Americans, white or black.

I find it curious that my health insurance company sends me constant reminders to have a colonoscopy but none to tell me to change to a diet that would lower my colon cancer risk 50 times over.

 

[Montecfo]

On the contrary. Your analogy is for someone who had not gotten screened and say, hey see I don't need screening and I have not died from colon cancer.

These are close friends of mine who had botched procedures. Our pool guy (owner) 's uncle is some big shot doctor at Cleveland Medical Center. Our pool guy said his uncle told him that the risk of colonoscopy going wrong is much higher than most people realize and he has never had a colonoscopy done himself. His advice to our pool guy is to have Cologuard every year. If insurance does not pay for it yearly, then just pay out of pocket. Remember that colonoscopy is used as a screening option and a polyp removal procedure. For people with regular colon cancer risk, there are 2 other screening options which are non-invasive. We make our own health care decisions.

Yes we make our own health decisions. But my point is no number of anecdotes, however tragic, can overcome the actual data.

This is just the science behind the medicine.

 

[Chuckanut]

The only time my primary care guy ever got visibly upset with me was when I waffled about the colonoscopy. So I had it done.

While they were prepping me for the exam the guy in the enclosure next to me was telling the assistant about his surgery and how he has to do certain thing now. After hearing his story I vowed to never complain about the colonoscopy.

 

[daylatedollarshort]

This study isn't a screening study but related to colon cancer and gut microbes so I thought people on this thread might find it interesting - "L. reuteri was able to prevent colorectal cancer in animal models through the inhibition of tumor progression. Findings showed that this bacterium was critical in the inhibition of tumor progression, the reduction in inflammation, and thus the prevention of tumor progression into carcinogenesis or further metastasis."(PDF) Lactobacillus reuteri's role in the prevention of colorectal cancer: a review of literature (researchgate.net)

L. reuteri also raises vitamin D levels, and low vitamin D levels have also been linked to colon cancer - Vitamin D and colon cancer (nih.gov).

There are cheap, non-risky tests for vitamin D (blood) and l. reuteri (gut), and correcting these deficiencies might aid in preventing the polyps from ever occurring.

 

[harllee]

The only time my primary care guy ever got visibly upset with me was when I waffled about the colonoscopy. So I had it done.

While they were prepping me for the exam the guy in the enclosure next to me was telling the assistant about his surgery and how he has to do certain thing now. After hearing his story I vowed to never complain about the colonoscopy.

When I turned 50 I had a primary care physician that would not allow any of her patients to stay as her patient unless they got a colonoscopy at age 50. She said she had lost too many patients to colon cancer and she was trying to make sure that did not happen to any more patients.

 

[chassis]

Bringing to the top to connect with recent discussion in another thread.

 

[Amethyst]

One of my friends, 63, swears she will never have another colonoscopy. She is such a sensible, belt-and-suspenders person in other ways, I can't understand it. So she says they've never found anything....ummm, that doesn't mean something can't decide to show up!

While they were prepping me for the exam the guy in the enclosure next to me was telling the assistant about his surgery and how he has to do certain thing now. After hearing his story I vowed to never complain about the colonoscopy.

 

[ShokWaveRider]

I am of a similar opinion, the last colonoscopy I had showed nothing, but I got ischemic colitis after my last one. It was painful and very uncomfortable for 2 weeks. All OK now. Doc, who is a very good one by the way, said it was caused by the prep and me not drinking enough water. He said I did not need another for 10 years anyway. I may think differently when the time comes.

 

[Dean56]

Think of it as preventative maintenance. Colon cancer can go undetected for years. That's why it is called the "Silent Killer". Sadly, when it is detected it's usually in it's stage 4 form. That's what happened to 2 of my family members. We lost both of them. Now regular scheduled colonoscopies are part of our life.

 

[COcheesehead]

I heard so many folks complain about getting a colonoscopy…the prep, the fasting, the this, the that. I’ve had two now. Clean on both. They are not that big of a deal.

 

[6miths]

Colorectal cancer is one of the most lethal cancers and also the most easily detected at an early stage and curable. The other cancer with similar characteristics is cervical cancer which is now largely preventable with the HPV vaccine.

As someone who is quite healthy and at low-risk for most things, I was very happy to get screened as soon as possible. Cologuard and colonoscopy both have pros and cons but eventually DNA based tests like Cologuard will probably become the standard for initial screening for low-risk individuals.

 

[athena53]

I heard so many folks complain about getting a colonoscopy…the prep, the fasting, the this, the that. I’ve had two now. Clean on both. They are not that big of a deal.

Well, I hate them but they're better than developing colon cancer (and I figure if I get colon cancer and survive there will be MANY more of those miserable tests in my future). They always find stuff to snip out so I'll be back every 5 years.

 

[Teacher Terry]

I intend to have one more and then I am done due to concern about my lining thinning and having a puncture during the procedure. I haven’t had any polyps. My siblings haven’t stopped because they have had many polyps.

 

[RetMD21]

I intend to have one more and then I am done due to concern about my lining thinning and having a puncture during the procedure. I haven’t had any polyps. My siblings haven’t stopped because they have had many polyps.

The recommendation is to continue screening through 75 and consider it from 75-85 in consultation with your doctor (USPSTF)

 

[Helen]

I had my covid test today and am now quarantining in prep for my Monday colonoscopy. I have one every three years. The first one was when I was 51 and they found 13 polyps. The last one they found a polyp on my appendix so I opted to have the appendix removed.

The colonoscopy prep that I am to drink cost over $200 without my insurance and $93 with insurance. It's mostly magnesium. Next time I will opt for Miralax or Suprep.

 

[harllee]

The recommendation is to continue screening through 75 and consider it from 75-85 in consultation with your doctor (USPSTF)

I had my third colonoscopy recently at age 70 (the other 2 were at age 50 and 60). I have never had any polyps or other issues so the doctor told me I should not have to have another colonoscopy unless I develop some issues.

 

[Dtail]

Well, I hate them but they're better than developing colon cancer (and I figure if I get colon cancer and survive there will be MANY more of those miserable tests in my future). They always find stuff to snip out so I'll be back every 5 years.

Same here. Always have benign polyps, so every 5 years for me.
The prep for one day is no real big deal. Dying of colon cancer is a bigger deal.