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Are colonoscopies worth it?

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Re: Are colonoscopies worth it?

#201

Post by drowsspa »

mft_ wrote: post #182

There's an interesting point made in a podcast (Huberman, perhaps) - which is that Colon Cancer could be totally eliminated as a cause of death, if we used screening via colonoscopy optimally. As in, play a thought experiment: * First, imagine everyone in the world gets a colonoscopy every day --> obviously, all cancers would be picked up, but this is infeasible for some reasons (e.g. cost, economic impact) and subop…

What's the prevalence of colon cancer within the general population? Per Bayes' rule, I doubt it's enough to decrease the level of false positives to an acceptable level.

Re: Are colonoscopies worth it?

#202

Post by touisteur »

fodkodrasz wrote: post #72
woleium wrote: post #47

Earlier quoted context omitted.

https://en.m.wikipedia.org/wiki/Ignaz_Semmelweis He had very sensible ideas about hand washing a hundred years before it was accepted by most doctors. He was a bit weird though, and ended up being ignored.

Weird as in saying the common practices are not correct, and here is my proposal for a better practice, as supported by statistics.

I can just imagine both how desperate you might feel when you discover that you've been (unwillingly) killing your patients, how you might refuse this reality of being a vector of health instead of the saviour or helper you picture yourself as and also how personable and convincing you'd need to be to get people past that.

Semmelweiss was apparently lacking in social graces, but I wouldn't be able to behave normally if I'd discovered what he discovered.

(Edit for coquilles and spacing)

Re: Are colonoscopies worth it?

#203

Post by bluGill »

mft_ wrote: post #182

There's an interesting point made in a podcast (Huberman, perhaps) - which is that Colon Cancer could be totally eliminated as a cause of death, if we used screening via colonoscopy optimally. As in, play a thought experiment: * First, imagine everyone in the world gets a colonoscopy every day --> obviously, all cancers would be picked up, but this is infeasible for some reasons (e.g. cost, economic impact) and subop…

Since you can't eat for a day before, colonoscopies daily would also prevent death by heart attack as everyone would starve to death in a couple months.

Re: Are colonoscopies worth it?

#204

Post by drowsspa »

technothrasher wrote: post #184
dkarras wrote: post #137

Earlier quoted context omitted.

I have not had one but closely monitored people that had a colonoscopy. The prep looks like worse than the colonoscopy itself.

I've had two. They were a breeze. In and out in 45 minutes, no discomfort, not a big deal. But sure, the prep is a little annoying.

"Little" annoying? God, having your rectum just spewing out urine-like shit as if it were a water tap is absolutely awful. I can't imagine doing that and then having a tube going up your damaged ass without anesthesia

Re: Are colonoscopies worth it?

#206

Post by [deleted] »

op00to wrote: post #169
sillysaurusx wrote: post #58

It’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 haven’t had hemorrhoids since I installed a bidet. Just passing on some info from one sensitive butthole to any others out there!

[deleted]

Re: Are colonoscopies worth it?

#207

Post by bluGill »

fsckboy wrote: post #96
stouset wrote: post #26

Earlier quoted context omitted.

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

does a cologuard false positive indicate a colonoscopy? if so, as long as the false negatives aren't substantially worse, it sounds like a win.

Yes. If it finds anything you get called very high risk and get right in. My doctor sent me to cologuard because the people doing colonoscopies had a year long waiting list, I don't need to get in, but if the test found something they would let me skip the line and i'd be in a few weeks later. Since it didn't i'm not in line at all, but I need a new test in three years, while the colonoscopie is good for ten.

Re: Are colonoscopies worth it?

#208

Post by maroonblazer »

raverbashing wrote: post #46
nwellinghoff wrote: post #19

Earlier quoted context omitted.

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.

And the big disadvantage that to get there your need to book 2 professionals (?) and take pretty much one day off, and there are risks associated with anesthesia and the procedure itself I don't think it scales (Not to mention the interests of doctors of suggesting things that make them more money) Edit: now I see TFA mentions risk of perforation and that the risk is smaller without anesthesia

You also need to find someone to transport you to/from the procedure.

I moved to a new city and didn't know anyone. I was told to get a colonoscopy for no other reason than I was 50. There was literally no one I could ask to take off half a weekday to accompany me.

Ended up doing the FIT test (stool sample) instead (and once/year thereafter) and 6 years on still haven't had a colonoscopy.

Re: Are colonoscopies worth it?

#209

Post by Supermancho »

polotics wrote: post #152
theodric wrote: post #94

Earlier quoted context omitted.

I've had two colonoscopies done in the last 10 years. The second was possibly unnecessary, but I pushed for it because I just really enjoy propofol. Maybe if more people knew that the sedative drugs used in the procedure are fun, they'd be more inclined to have it done. Edit: downvotes? Really!? I'm 100% fucking serious! Work any angle to get people to test!

I am really curious as to why you enjoy propofol: is this in any way producing euphoria? Normally you should just feel really sedated then pass out, with little difference between this experience and being just tired then asleep. is the large-ish quantity of white fluid getting into you not off-putting?

> I pushed for it because I just really enjoy propofol

After about the 4th? time I had it (I've had 9 cardioversions, along with many types of surgeries), I realized I liked propofol. By the 6th time, it was the highlight of any procedure. I found that the high comes from trying to fight the anesthetic and the amazing quality of sleep you get, plus I will agree the wakeup is tricky. Be careful about what you're really obsessed with, as you'll likely talk about random aspects of your hobby as you come out of the stupor.

The next best thing, I would say is Demoral, which gives me the instant feeling of being peak-drunk without the need for all the troublesome alcohol. Anything acute and severe, that cannot be immediately triaged, can justify getting an injection. This drug is very tightly controlled now.

I do avoid pain killers as a personal policy, to ensure I am aware of what's going on in my body at all time (since it's a delicate thing). That being said, I can understand Michael Jackson's addiction.

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