Interesting. I wish I'd known that last week when I went in for my third colonoscopy of the last ten years. As everyone says, the procedure is nothing -- you're completely doped up. It's the prep. And I'm on a med that slows gastric emptying so it was extra fun. It's fascinating to learn that the U.S. is the primary place we do them. I suspect they must be really lucrative, because 1) there is a stand-alone gastro practice every five miles, seemingly; and 2) if you miss your appointment they call and bug you endlessly to reschedule. They don't love me personally enough to care that much about my health. They want their money.
Well, keep in mind that the only debate is about how effective colonoscopies are for screening. If anything shows up, then a colonoscopy is the recommended follow-up pretty much everywhere (that has the resources to do things like colonoscopies).
Great article. As a stats geek and recipient of multiple colonoscopies, I loved it. I think for an individual with family or personal risk, the data of the study definitely support colonoscopies for screening.
As for American gastroenterologists getting their knickers in a twist over it and exaggerating the benefits, people always talk their book, don't they? I have yet to meet any person anywhere who does X for a living agree that X is a pointless endeavor.
But if you want good colonoscopy jokes, read Dave Barry's old article on the topic.
It certainly makes sense that the benefit of colonoscopies will be larger for someone at higher risk, so that would push the tradeoff in that direction. (And it may be that colonoscopies are worth it for everyone!)
As a person who suffers from specialist-diagnosed, colonoscopy-verified Ulcerative Colitis, I feel like I should be running an AMA on this. But as somebody who is unusually skeptical of the competency of medical professionals, who has also managed his condition extraordinarily well, I feel reticent to comment. Either way, I appreciate your writing this article and find little to quibble over in your takeaways.
Personal story (so an N=1) - my colon caner in Australia was first noticed by government issued FOBT, followed in about a week or so with a colonoscopy and then surgery once confirmed. All up, about a month from FOBT to surgery (enter comment here about socialised medical access). Two years later, my surgeon has switched me from follow up colonoscopys to FOBT to monitor. I never found the colonoscopy to be too intrusive (I hate the regular blood tests more than a colonoscopy) - but I can see the dangers in a larger group and the need for good FOBTs to cover more of the population.
Almost had a reason to cite this on the job today since I was asked to look into alternatives to standard colonoscopy bowel prep and was ready to be like "are you sure they actually need the long tube??" until I saw on the chart they already had a positive fecal occult blood test.
Interesting. I wish I'd known that last week when I went in for my third colonoscopy of the last ten years. As everyone says, the procedure is nothing -- you're completely doped up. It's the prep. And I'm on a med that slows gastric emptying so it was extra fun. It's fascinating to learn that the U.S. is the primary place we do them. I suspect they must be really lucrative, because 1) there is a stand-alone gastro practice every five miles, seemingly; and 2) if you miss your appointment they call and bug you endlessly to reschedule. They don't love me personally enough to care that much about my health. They want their money.
Well, keep in mind that the only debate is about how effective colonoscopies are for screening. If anything shows up, then a colonoscopy is the recommended follow-up pretty much everywhere (that has the resources to do things like colonoscopies).
Great article. As a stats geek and recipient of multiple colonoscopies, I loved it. I think for an individual with family or personal risk, the data of the study definitely support colonoscopies for screening.
As for American gastroenterologists getting their knickers in a twist over it and exaggerating the benefits, people always talk their book, don't they? I have yet to meet any person anywhere who does X for a living agree that X is a pointless endeavor.
But if you want good colonoscopy jokes, read Dave Barry's old article on the topic.
It certainly makes sense that the benefit of colonoscopies will be larger for someone at higher risk, so that would push the tradeoff in that direction. (And it may be that colonoscopies are worth it for everyone!)
For anyone interested, here's Dave Barry's article: https://www.miamiherald.com/living/liv-columns-blogs/dave-barry/article1928847.html
As a person who suffers from specialist-diagnosed, colonoscopy-verified Ulcerative Colitis, I feel like I should be running an AMA on this. But as somebody who is unusually skeptical of the competency of medical professionals, who has also managed his condition extraordinarily well, I feel reticent to comment. Either way, I appreciate your writing this article and find little to quibble over in your takeaways.
Personal story (so an N=1) - my colon caner in Australia was first noticed by government issued FOBT, followed in about a week or so with a colonoscopy and then surgery once confirmed. All up, about a month from FOBT to surgery (enter comment here about socialised medical access). Two years later, my surgeon has switched me from follow up colonoscopys to FOBT to monitor. I never found the colonoscopy to be too intrusive (I hate the regular blood tests more than a colonoscopy) - but I can see the dangers in a larger group and the need for good FOBTs to cover more of the population.
Almost had a reason to cite this on the job today since I was asked to look into alternatives to standard colonoscopy bowel prep and was ready to be like "are you sure they actually need the long tube??" until I saw on the chart they already had a positive fecal occult blood test.