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Are colonoscopies worth it?

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Re: Are colonoscopies worth it?

#51

Post by matheusmoreira »

huytersd wrote: post #31
stouset wrote: post #26

Earlier quoted context omitted.

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?

Manufacturer claims around 8% false negatives, 92%-94% sensitivity, 87%-90% specificity and 99.94% negative predictive value.

Published study:

https://pubmed.ncbi.nlm.nih.gov/24645800/

It appears they calculated the negative predictive value based on the population sample of that study. It may differ significantly from the negative predictive value for the general population.

Re: Are colonoscopies worth it?

#53

Post by atlgator »

My father died of colon cancer at 52, so I've been getting colonoscopies every 3-5 years since I was 22. Yes, that's really early, but in the span between age 30-33, I grew a large polyp. My doctor removed it and it turned out non-cancerous, but if I waited until 40+ to start who knows?

Re: Are colonoscopies worth it?

#54

Post by uxp8u61q »

all2 wrote: post #43
woleium wrote: post #35

Earlier quoted context omitted.

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

I don't know what this means. Can you expand on your statement? Who is this person? What would we be farther forward to ?

Here's a tip for the future: typing a name into Wikipedia usually yields great results.

Re: Are colonoscopies worth it?

#55

Post by bumbledraven »

In The Value of Colon Cancer Screening (https://www.blackliszt.com/2023/01/value-of-colon-cancer-scr...), David B. Black argues that colonoscopies are a net negative, based on the “high confidence result of harm based on millions of patients [1], vs. the nearly identical low-confidence results of benefit from the NordiCC study”.

[1] “14.6 major bleeding events per 10,000 colonoscopies (95% CI, 9.4-19.9; 20 studies; n = 5,172,508) and 3.1 perforations per 10,000 colonoscopies (95% CI, 2.3-4.0; 26 studies; n = 5,272,600)”

Re: Are colonoscopies worth it?

#56

Post by nirav72 »

EgregiousCube wrote: post #4

You mean I get scoped every few years and it’s not even a thing??!

Dont think its suppose to be every few years. I was told it’s good for 10 years. Unless you are in high risk category. Specifically one with a family history of colon cancer. That’s what I was told when I got one as soon as I turned 50. I don’t have to get another one until I’m closer to 60.

Re: Are colonoscopies worth it?

#58

Post by sillysaurusx »

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 minutes for it to stop. Other times I would see blood, but no bleeding.

These are bad signs. If you see this, don’t do what I did. I was gambling with my life. Remember that popular video game commenter that died from this? Totalbiscuit? He concealed his, and he lost.

The most unexpected thing is that when I actually wanted one, the process took over two years. And that was after a year or so of periodically mentioning it to the doctors, who would give me a sheet of numbers to call and I never bothered. Those three years could have been the difference.

Turns out, there’s nothing wrong with me. It was hemorrhoids. You might think you’re smart enough to tell the difference. I thought so. I was a cocky idiot who could’ve died from cancer before seeing my daughter get married.

Just get one if you see something. The final paragraph of the article pleads you to. The peace of mind alone was worth the small unpleasantness and major logistical annoyance.

Re: Are colonoscopies worth it?

#59

Post by iaseiadit »

gcheong wrote: post #38
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.

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.

It’s great if you’re in the 40%.

Re: Are colonoscopies worth it?

#60

Post by ghaff »

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

Well, in the US, they're following normal protocol. It would probably be irresponsible for them to try to dissuade you from a colonoscopy. But, yes, it's a day involving a gastroenterologist, typically an anesthesiologist, nurses presumably, and someone to take to back and forth from the procedure. It's definitely not standard lab work.
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