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Overall, the colorectal cancer story is encouraging

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Re: Overall, the colorectal cancer story is encouraging

#61

Post by owenversteeg »

reducesuffering wrote: post #12
proee wrote: post #2

Wow, I had no idea there is a 15X increase for endurance athletes. Make me want to dial down the running a bit, which make you wonder where the sweet spot is for distance training.

It's not simply endurance athletes though. It was 2x ultra-marathons >26 miles, or at least 5 marathons completed.

>2x ultra-marathons >26 miles, or at least 5 marathons completed

Yes, and it seems like it's really a 7.5x risk increase. Still pretty spectacular, though!

I really wonder what could cause that. Randomly throwing out possible causes: 1) blood redirected away from gut, 2) overuse of NSAIDS, 3) ultraprocessed foods (gels etc), 4) strange microbiome issues (gels + stress in gut from extreme exertion = altered gut flora?)

The study that found the result is DOI: 10.1200/JCO.2025.43.16_suppl.3619

Re: Overall, the colorectal cancer story is encouraging

#62

Post by pfannkuchen »

greygoo222 wrote: post #58
inglor_cz wrote: post #53

Earlier quoted context omitted.

I don't assume anything. From what we know about health of the last surviving hunter-gatherers, they suffer significantly less from "diseases of civilization" when taken in proportion to their settled neighbours. Some of those diseases (such as high blood pressure or diabetes 2nd type) seem to be totally absent in them. Cancers do happen, but not as often. This pattern is quite old. Already ancient Egyptians suffered…

I won't bother checking or disputing the accuracy of your factual claims, because it does not matter. Colorectal cancer is not the same thing as high blood pressure, or type 2 diabetes, or any other cancer that isn't colorectal cancer. Diseases are not a monolith and you cannot assume low risk of some diseases means low risk of others. That is wild guesswork passed off as logic, like measuring the shadow your testicl…

Absolutely, we may have a depressed rate of CRC where ultramarathoners just get back up to the historical baseline. Who knows, but we don’t know it isn’t that.

Re: Overall, the colorectal cancer story is encouraging

#63

Post by lotsofpulp »

helterskelter wrote: post #40
y-curious wrote: post #16

I’m in my early 30s and am starting to think about getting a screening. Problem is, it’s not trivial to do. You have to really upsell your doctor to get one so early, even though it’s a relatively benign procedure. There is a noninvasive testing method called Shield but it is way too flawed to be reliable (with poor positive rates for malignant tumors)

Lie about family history, but even colonoscopies are not perfect; I just had somebody in my family die of CRC because... - They had symptoms and wanted a screening, but their PCP repeatedly denied them a referral for like a year because they were "too young". - They lied about family history after symptoms got worse and got their referral. - They got the colonoscopy which came back clean, and then symptoms continued…

>Also...apparently doctors wanted to lower the screening age to like 35, but insurance companies fought it, so it's at 45.

On this website, it is frequently opined that because health insurers have a legal minimum medical loss ratio, that health insurers prefer inflated costs so that their medical losses are higher, which means their premiums can be higher, which means their revenue is higher, which means their profit is higher.

I would have thought health insurers would support a lower screening age, especially since it would inflate costs for all insurers so everyone's cut of the now bigger pie gets bigger.

Re: Overall, the colorectal cancer story is encouraging

#64

Post by anoojb »

lotsofpulp wrote: post #59
nphardon wrote: post #39

Earlier quoted context omitted.

If you tell your doctor that a parent had polyps removed (say, recently), that will give you your best chance of getting one. Most likely, if you're in an even remotely progressive area, your doc wants you to have one, but their hands are tied by the insurance company. Afaik you dont have to provide any proof of your claim re parental polyps.

> but their hands are tied by the insurance company. Doctors' ability to prescribe or refer is never restricted by an insurance company. If they think a patient should get whatever healthcare, they are free to say it.

In CA, my doctor can refer me to get a Cologuard. But it's private pay, and they want payment up front since isurance companies don't restrict doctor's ability, only reimbursement.

So they may not be willing (even though they are able) perform procedure/test if they aren't confident they'll get paid.

Re: Overall, the colorectal cancer story is encouraging

#65

Post by PenguinCoder »

proee wrote: post #2

Wow, I had no idea there is a 15X increase for endurance athletes. Make me want to dial down the running a bit, which make you wonder where the sweet spot is for distance training.

Interesting, I wasn't aware of that connection either. I was diagnosed with stage IV colon cancer, but was identified as 'genetic' and not caused by diet or lifestyle. I used to be a heavy runner too, done a few marathons, and plenty more 10k, 8ks etc. Wonder if that could be a correlation... Treatments have it contained/in maintenance so at least I have that going for me.

Re: Overall, the colorectal cancer story is encouraging

#67

Post by sigmoid10 »

ZeeSee wrote: post #20
proee wrote: post #2

Wow, I had no idea there is a 15X increase for endurance athletes. Make me want to dial down the running a bit, which make you wonder where the sweet spot is for distance training.

It's rare but can happen where long distance running causes ischemic colitis which is where on a long run enough blood is diverted from the large intestine that it damages the intestine long term. It isn't surprising to me that there's higher likelihood of colon cancer given this. It seems like repeated bouts of lower blood for the intestine on long runs has a cumulative impact and damages the colon even if it doesn'…

This theory has been put forward, but it's important to point out that there is no real evidence yet. An alternative theory is diet, which is also the leading theory for increasing incidences in non-athletes. Highly processed, calorie dense foods have been on the watchlist for a while, and ultra endurance athletes have a special need for these to satisfy their caloric requirements. It could also be a combination of these factors or something else that was missed entirely so far.

Re: Overall, the colorectal cancer story is encouraging

#68

Post by nikole9696 »

elric wrote: post #28

If anyone here is up for disrupting the medical field: please come up with a colonoscopy-equivalent with a less awful prep experience.

This may be regional but I just had pills. It was fine. My first one had that terrible salty liquid and I cannot stand the salt. I had a very hard time with it, despite adding some flavoring. I just can't drink salt water. So my second one I got pills and it was miles and miles easier. Now the hardest part is fasting for a day.

Re: Overall, the colorectal cancer story is encouraging

#69

Post by inglor_cz »

greygoo222 wrote: post #58
inglor_cz wrote: post #53

Earlier quoted context omitted.

I don't assume anything. From what we know about health of the last surviving hunter-gatherers, they suffer significantly less from "diseases of civilization" when taken in proportion to their settled neighbours. Some of those diseases (such as high blood pressure or diabetes 2nd type) seem to be totally absent in them. Cancers do happen, but not as often. This pattern is quite old. Already ancient Egyptians suffered…

I won't bother checking or disputing the accuracy of your factual claims, because it does not matter. Colorectal cancer is not the same thing as high blood pressure, or type 2 diabetes, or any other cancer that isn't colorectal cancer. Diseases are not a monolith and you cannot assume low risk of some diseases means low risk of others. That is wild guesswork passed off as logic, like measuring the shadow your testicl…

"Diseases are not a monolith and you cannot assume low risk of some diseases means low risk of others. That is wild guesswork passed off as logic..."

Diseases are not a monolith, but they do tend to arise and fall in some specific clusters, and that is not "logic", good or bad (too many computer-minded people drag logic into the chaos that is biology), but rather a long-time empirical observation, albeit with some exceptions.

Re: Overall, the colorectal cancer story is encouraging

#70

Post by pfannkuchen »

greygoo222 wrote: post #50
kazinator wrote: post #24

If you screen more people for the disease, and do it better, such that you reduce the incidences and fatalities in the 50+ cohort, that improvement logically implies that you must be catching incidences in the under 50 cohort. So it's going to skew the numbers. Incidences that would have been tallied in the 50+ cohort, are now counted in the under 50. E.g. a 45-year-old with a latent colorectal cancer who would previ…

This mostly can't explain the fact that mortality is also rising in under 50s. It is true mortality is rising less than incident, and that a small proportion instances of mortality could be deaths related to reasonable risks taken on from treatment side effects (to make up numbers, it makes sense to take a 5% chance of dying from treatment this year over a 80% chance of dying from cancer in 5 years), but this is prob…

Does treatment ever speed up death? Given that chemo is super hard on the body I imagine it could? That might just account for your use of “mostly”, though.
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