Because it was colon-ized?
Are colonoscopies worth it?
81–90 of 296 posts
Re: Are colonoscopies worth it?
#82It’s time to share something personal again. When I was 20, I vividly remember being in the bathroom at my workplace when a large amount of blood started coming out. I did what any smart, effective 20yo would do: ignored it because I was embarrassed. Fast forward 10 years, and I’d been ignoring it for a decade. It had continued to happen every few months. Sometimes the blood was so bad I’d have to wait up to 20 minut…
If it is RED blood, it is a vein that breaks when the your stool passes. Most likely hemorrhoids. The problem is when you have BLACK blood in the stool. That may be an internal bleeding.
Red blood consistently still deserves to be checked out.
Re: Are colonoscopies worth it?
#83Here a colonoscopy is adviced by my doctor for anyone aged 50.
She told me the free screening kits for bowel cancer the government sends out is mostly an awareness campaign as those tests are extremely unreliable.
Re: Are colonoscopies worth it?
#84It’s time to share something personal again. When I was 20, I vividly remember being in the bathroom at my workplace when a large amount of blood started coming out. I did what any smart, effective 20yo would do: ignored it because I was embarrassed. Fast forward 10 years, and I’d been ignoring it for a decade. It had continued to happen every few months. Sometimes the blood was so bad I’d have to wait up to 20 minut…
> worth the small unpleasantness and major logistical annoyance. I’ve gone through it twice now. Both times, the most annoying part was the 2 or so hours they make you sit there in a hospital gown with no phone or electronics and nothing to do, while you are starving and uncomfortable and waiting to have the procedure. I don’t know if it’s like that everywhere. But would it really be that bad to let people hang on to…
I went in, put the hospital robe on, 20 min later I was under anesthesia.
I could keep my phone anytime (why would you not?).
Now, in France you prepare yourself before and that's another horrifying story :)
Re: Are colonoscopies worth it?
#85The article doesn't cover this, but it's worth pointing out why the study asks this particular question. With a single-payer system the Nordic countries want to know what the ROI is if we sent letters out to everyone above a certain age offering a free colonoscopy. The study is well-designed to answer that question.
The study does a poor job of helping an individual asking a similar but different question: Is it worthwhile for me to pay out of pocket for a colonoscopy?
The latter question is very important in a system that isn't single-payer and so this has sparked a lot of debate in e.g the US.
Re: Are colonoscopies worth it?
#86As far as I know, countries outside the USA that recommend it are Switzerland, Germany, and Austria: https://publichealthreviews.biomedcentral.com/articles/10.11...
Yeah gastroenterologists in Germany are a shitshow (no pun intended). They all invested heavily into colonoscopy equipment and now must always do them for financial reasons. I was outright refused treatment when i didn't want colonoscopy for celiac disease. Practical medicine in Germany is totally stuck in the 90s, cause of some deadlock between doctors, pharma and health insurance.
Re: Are colonoscopies worth it?
#87It’s time to share something personal again. When I was 20, I vividly remember being in the bathroom at my workplace when a large amount of blood started coming out. I did what any smart, effective 20yo would do: ignored it because I was embarrassed. Fast forward 10 years, and I’d been ignoring it for a decade. It had continued to happen every few months. Sometimes the blood was so bad I’d have to wait up to 20 minut…
I've had the experience that... I was told when I was separating from the military, at 25b(I don't know why and I didn't ask...), to expect a colonoscopy. It didn't happen. I mentioned it to my GP a couple of years later, he said probably between 30 and 35... Now I'm in my 40s. It's perpetually a couple of years away.
I get the sense from this, and from other anecdotes in life, that preventative maintenance, of all flavors, is something we used to do, for a brief period of time, but that we don't really do anymore.
Re: Are colonoscopies worth it?
#88I 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).
Randomized controlled trials are great, they are incredibly certain to be right.
But experience has a whole other quality, it is much less reliable but a whole lot more comprehensive. An RCT can only measure effects on what can be used to select a large group of people. It cannot measure the effects of a weird anomaly that is recorded nowhere. Meanwhile experience can extrapolate from a very few examples.
So it is not at all obvious that we should favor RCTs over experience. Because they have very different things they can measure.
Re: Are colonoscopies worth it?
#89Earlier quoted context omitted.
Yeah, I thought the discussion of how you couldn't just directly compare people that accepted the colonoscopy invitation with the control group was really interesting, and non-obvious (at least to people like me that don't design studies). It reminds me of the fundamental problem that all surveys have in terms of the bias introduced by being limited to "people who agree to take surveys".
Any self-selection where higher risk individuals opt-in more, increases benefit/cost ratios. That seems like a pro invitation argument. (I.e. pro treatment for the invited + opt-in cohort.)
But alternative screenings with a wider acceptance could have a higher 'benefit-cost' for a lower 'benefit/cost'.
Re: Are colonoscopies worth it?
#90Earlier quoted context omitted.
The problem with medical interventions, especially tests, is that they sometimes work. There will always be success stories. The big question is: are those success stories worth it, and are there other paths to those same success stories.
> The problem with medical interventions, especially tests, is that they sometimes work. There will always be success stories. Do you prefer medical interventions that never work? > are there other paths to those same success stories. Yes, in the US other options include high sensitivity FOBT, FIT, sDNA-FIT and CT colonography.
I think the original sentence was meant more like 'the problem with unproductive tests is...'
Where unproductive means that the total cost benefit of doing the test is negative. And even procedures that never help can 'cure' people just by regression to the mean.