Are colonoscopies worth it? • Hacker News Board

Re: Are colonoscopies worth it?

#31

Post by huytersd » Sun, Oct 29, 2023, 5:16 AM UTC

stouset wrote: post #26

joshuaheard wrote: post #16

My doctor recommended Cologuard, a test of your stool sample for cancerous DNA, instead of a colonoscopy. I can't imagine taking a colonoscopy now.

Cologuard has a significantly high false positive rate, as far as I’m aware.

False positives are bad but not disastrous. How bad are the false negatives?

Re: Are colonoscopies worth it?

#32

Post by huytersd » Sun, Oct 29, 2023, 5:17 AM UTC

jay_kyburz wrote: post #17

LarsDu88 wrote: post #5

Colonoscopies come with potential for complications. There are actually a number of companies which have either released or plan to release non-invasive colorectal cancer screening based on blood dna sequencing. GRAIL, Freenome, and Guardant all have tests out or coming down the pipeline.

I got a letter from the government last year saying they wanted some of my poo, so I sent them some. The whole thing was weird, but much better than visiting a doctor. I'm in Australia.

They have your DNA now.

Re: Are colonoscopies worth it?

#33

Post by huytersd » Sun, Oct 29, 2023, 5:18 AM UTC

shoelessone wrote: post #23

I have no first hand knowledge of this but I've heard that colonoscopies are very common in S. Korea, even starting at younger ages. Can anybody comment on this?

I have heard they have a massive drinking culture without the genes to handle it so stomach and colon cancers show up a lot.

Re: Are colonoscopies worth it?

#34

Post by irrational » Sun, Oct 29, 2023, 5:18 AM UTC

My brother had stage 3b colon cancer caught by a colonoscopy. He was treated and is still alive, so… that seems pretty good to me.

My company health plan recently announced that starting next year you can get a free Colonoscopy every year.

Re: Are colonoscopies worth it?

#35

Post by woleium » Sun, Oct 29, 2023, 5:18 AM UTC

Barrin92 wrote: post #30

abigail95 wrote: post #24

I don't know any gastroenterologist over 40 that hasn't had one (Australia). Do I take the government advice or copy what the doctors themselves are doing?

This is a large, randomized control trial, so obviously you should value this significantly higher than whatever doctors are doing to themselves. (history has more than a few examples of doctors practicing medicine that didn't make a whole lot of sense).

If only Semmelweis wasn’t such a strange chap, we’d have been much more further forward now.

Re: Are colonoscopies worth it?

#36

Post by matheusmoreira » Sun, Oct 29, 2023, 5:20 AM UTC

stouset wrote: post #26

joshuaheard wrote: post #16

My doctor recommended Cologuard, a test of your stool sample for cancerous DNA, instead of a colonoscopy. I can't imagine taking a colonoscopy now.

Cologuard has a significantly high false positive rate, as far as I’m aware.

All screening tests do. In general, cancer screening employs highly sensitive tests which are supposed to react to anything that even remotely looks like cancer. Negative results are relatively trustworthy while positive results justify further testing with more specific tests which may be more risky, more expensive or both. Colonoscopy is an example of a test that is both expensive and risky.

Re: Are colonoscopies worth it?

#37

Post by tedunangst » Sun, Oct 29, 2023, 5:23 AM UTC

smnrchrds wrote: post #20

tedunangst wrote: post #12

Article doesn't actually answer the question? Certainly interesting information about the topic and efficacy, but it doesn't really explain how the current situation came about. Why is my neighbor driving around on a donut? I could write 3000 words on the history of tires, the assorted trade offs of trunk storage vs spare diameter, the geographical distribution of potholes, etc., but none of that explains why the don…

I was satisfied with the answer given in the Discussion section at the end of the article.

Okay, thanks, went back and read it again. I may have preferred more, but it is there.

Re: Are colonoscopies worth it?

#38

Post by gcheong » Sun, Oct 29, 2023, 5:24 AM UTC

nwellinghoff wrote: post #19

joshuaheard wrote: post #16

My doctor recommended Cologuard, a test of your stool sample for cancerous DNA, instead of a colonoscopy. I can't imagine taking a colonoscopy now.

Colonoscopy has a big advantage in that they are already in there. If they see anything forming that is pre-cancerous they can take it out before it turns into a problem that would show up on a Cologuard test.

But that’s also highly dependent on how good the doctor is at finding the problems. Apparently doctors in the US find precancerous polyps 40% of the time according to the article. That may not be so great given the time between screenings (ten years) if one is missed.

Re: Are colonoscopies worth it?

#39

Post by crossroadsguy » Sun, Oct 29, 2023, 5:24 AM UTC

smnrchrds wrote: post #20

tedunangst wrote: post #12

Article doesn't actually answer the question? Certainly interesting information about the topic and efficacy, but it doesn't really explain how the current situation came about. Why is my neighbor driving around on a donut? I could write 3000 words on the history of tires, the assorted trade offs of trunk storage vs spare diameter, the geographical distribution of potholes, etc., but none of that explains why the don…

I was satisfied with the answer given in the Discussion section at the end of the article.

If someone else hasn't clicked on the article link (people still do that?) it says literally this:

  Are colonoscopies better than other screening methods? I don’t know. Maybe!

Re: Are colonoscopies worth it?

#40

Post by methou » Sun, Oct 29, 2023, 5:25 AM UTC

My uncle had one, it almost killed him when the probe breached his colon causing an internal bleeding. It was done with anesthesia, which according to him could be a major contributor to the incident.