Hacker News Board Hacker News, browsed like a classic message board
Live data from Hacker News

Are colonoscopies worth it?

asteriskmag.com

Post reply on HN
Print view View original

181–190 of 296 posts

Re: Are colonoscopies worth it?

#181

Post by mft_ »

hermitcrab wrote: post #120

>3. It’s irresponsible to call colonoscopies “invasive” (as CNN did) since that might make people think they are unpleasant and not do them. LOL. It hard to imagine anything much more invasive than having a metal tube (with light and camera) shoved up your arse. It is definitely unpleasant. I speak from personal experience. That said, it is less unpleasant than bowel cancer. So don't be put off if you really need to…

> It hard to imagine anything much more invasive than having a metal tube (with light and camera) shoved up your arse.

Well, how about an operation where sharp tools are used to slice open parts of your body that are otherwise entirely sealed, by design? To my mind, that's at least an order of magnitude more unpleasant and invasive.

> It's not that bad.

Totally agree. At commented elsewhere here, the prep process isn't that bad, and is still much worse than the procedure itself.

Re: Are colonoscopies worth it?

#182

Post by mft_ »

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 suboptimal for others (e.g. iatrogenic harm, human cost).

* So, using data, apply colonoscopies more sparingly, based on risk factors such as age, genetics, family history --> if this is done right you'd be able to pick up every colon cancer in its very early stages, either at a pre-cancerous stage, or an entirely curable stage.

Re: Are colonoscopies worth it?

#183

Post by ekianjo »

hackandthink wrote: post #123
ekianjo wrote: post #10

Earlier quoted context omitted.

Data does not seem to indicate better survival odds so whats the point?

There would be an reduction of 37% in diagnoses if everyone would have accepted the treatment (but no data for mortality). How significant is reducing a small risk (1%) significantly? (Base rate fallacy) "The right graph compares those results to the observed outcomes for acceptors in our branch of the multiverse, where they did have colonoscopies. At the end of the trial, there’s a reduction of 37%. Unfortunately, d…

> (but no data for mortality).

I have seen the data for mortality before in at least one publication if not more, and it clearly showed that the increase rate in diagnosis did not result in improved outcomes for survival, which is precisely why colonoscopy has a very bad ROI right now

Re: Are colonoscopies worth it?

#184

Post by technothrasher »

dkarras wrote: post #137
hermitcrab wrote: post #120

>3. It’s irresponsible to call colonoscopies “invasive” (as CNN did) since that might make people think they are unpleasant and not do them. LOL. It hard to imagine anything much more invasive than having a metal tube (with light and camera) shoved up your arse. It is definitely unpleasant. I speak from personal experience. That said, it is less unpleasant than bowel cancer. So don't be put off if you really need to…

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.

Re: Are colonoscopies worth it?

#185

Post by JoeAltmaier »

Just stopped eating three days before. Forget the drugs and liquids.

Took no anesthetic for the procedure. Not really bad; just embarrassing, get over yourself.

Drove myself home ten minutes after. No problems.

Have to be good with fasting. Mostly it's a matter of habit, remembering not to graze in the evening. I don't feel hunger as a big deal; your mileage may vary.

Re: Are colonoscopies worth it?

#186

Post by Tabular-Iceberg »

When a friend of mine had one he told the staff "too bad I'm not gay or I would have enjoyed this".

Which made me wonder if any research had been done on how many times per day doctors and nurses administering colonoscopies have to hear this line.

Re: Are colonoscopies worth it?

#187

Post by oarfish »

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…

> colonoscopy every day --> obviously, all cancers would be picked up

Would be the first medical test with 100% sensitivity probably?

Re: Are colonoscopies worth it?

#188

Post by denton-scratch »

youngtaff wrote: post #153
maxbond wrote: post #70

Earlier quoted context omitted.

Thank you for sharing. I'll share a story to help destigmatize. A few months ago I was taken completely out of commission by GI symptoms, just hours and hours of pain and vomiting. It turned out I had an infection, but the infection caused there to be shapes on my intestine that apparently looked vaguely like Crohn's disease on the MRI (or something, I'm not a radiologist, my understanding is pretty vague. There were…

Yeh, the prep is the worst… Might be the skill of the surgeon who did my three colonoscopies (and the fentanyl sedation) but I didn’t fund the actual procedure too bad It’s quite interesting seeing you own insides and the colonoscope they used for me had a transmitter the the head so you could see it’s shape as it snaked through the colon

I find the prep really hard to take. It doesn't taste nice, and it involves drinking much more fluid than I'm used to. I had a sigmoidoscopy about 20 years ago; instead of laxatives, they gave me an enema, whose effects I found surprisingly swift and violent. An enema won't work for a colonoscopy, because it only cleans out the sigmoid colon.

The colonoscopy is also extremely unpleasant; not exactly painful, but it made me groan repeatedly. The procedure lasts about an hour. I wasn't allowed sedatives, because I drink a lot; and no gas either, because something something, like I was going home under my own steam.

I've had three colonoscopies in the last five years, two last year (the second was to check up on the sites of the plaque removals from the first. They're threatening to send me for another check in January. I'm not yet sure if I will comply - I'm feeling overtreated.

I was sent for these procedures as a result of the self-administered fecal blood test, that everyone over (I think) 60 gets on the NHS. These were not screening tests.

> Might be the skill of the surgeon

My procedures were performed by a specialist colonoscopist, supported by a roomful of nurses and technicians (about 5 of them, I think). Plaque removal might be termed "surgery", but it's quite a long way from the scalpels-and-forceps type. The machine is very cool, and probably very expensive; in addition to the camera, it carries a wire loop for removing plaques, and another device for tattooing the sites of removed plaques. And they track the location of the tube with a continuous X-ray. But I guess most of the cost is the staff.

Re: Are colonoscopies worth it?

#189

Post by Tabular-Iceberg »

labster wrote: post #21
eastern wrote: post #14

The sad thing about the article is that skirts around mentioning the possibility that the American disease industry hates this trial because it will reduce their income. The good thing about the article is that it has a colonoscopy joke that also involves (bonus for the HN crowd) Bayesians.

Did you read the whole article? It definitely mentions cost and financial interest in the discussion section.

Isn't asking people if they read the article frowned upon here on HN?

Re: Are colonoscopies worth it?

#190

Post by fulafel »

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…

Would detecting all cancer cells there be useful? The immune system being the first line of defense.
Post reply on HN