Elsewhere on the site this week, we reviewed several news stories about claims for a new “laxative-free colonoscopy.” Here’s more on alternatives to traditional colonoscopy in a guest post by Harold DeMonaco, MS – one of our expert editors on HealthNewsReview.org but also Director of the Innovation Support Center at the Massachusetts General Hospital.
—————————————————————————–
I just had the pleasure of undergoing my third screening colonoscopy. At nearly 64 years of age, I should not have been scheduled until age 70. But a small polyp was removed the last time, so the time interval recommendation was shortened. As the gastroenterologist said, “It was one of the types we are interested in.” This time around, three polyps were removed and I await the word from the pathologist to see if my friendly gastroenterologist will have a similar interest in one or more of the triplets. I suspect I will be crossing the threshold into the GI unit in the next few years yet again.
For those who have never had the colonoscopy experience, I would point you to an article written by Dave Barry for the Miami Herald. While a bit over the top, it is still worth reading perhaps after you have had the procedure. It is not quite as bad as he makes it out to be but the space shuttle analogy is darned close. And you will never have the same feelings about Abba and “Dancing Queen.”
Screening tests have pluses and minuses. All have risks and presumed benefits. Colon cancer is the second leading cause of cancer death in the United States. It has been estimated that if every adult over the age of 50 years were screened about 19,000 lives would be spared annually. Colon cancer can take years to develop so early detection has been shown to reduce the risk of advanced disease and death. The U.S. Preventive Services Task Force published a set of recommendations in 2008 and recommended a staggered arrangement for screening beginning at 50 years of age and ending at age 75 years. They also examined the relative value of each of the screening methods currently available. Colonoscopy is the gold standard. Colonoscopy is also operator-dependent. Not every physician can detect small polyps with equal ability. Colonoscopy is not without risk. About 4 out of every 10,000 people will have serious complication. And, colonoscopies are expensive. The HealthCare Blue Book lists a fair price of $1,360 for both physician and clinic fees. This is a major barrier for low income people without healthcare insurance and perhaps one of the reasons that low income and minorities bear a disproportionate burden of colon cancer.
Other less expensive tests have a place given the access to care and cost associated with colonoscopy. Here is what the Preventive Services Task Force said about them:
“The relative sensitivity and specificity of the different colorectal screening tests with adequate data to assess cancer detection—colonoscopy, flexible sigmoidoscopy, and fecal tests—can be depicted as follows:
Sensitivity: Hemoccult II < fecal immunochemical tests ? Hemoccult SENSA ? flexible sigmoidoscopy < colonoscopy
Specificity: Hemoccult SENSA < fecal immunochemical tests ? Hemoccult II < flexible sigmoidoscopy = colonoscopy”
So, if you are not necessarily interested in recreating a launch of the space shuttle, there are alternatives.
———————————————————-
Related note:
Dr. James Allison, a clinical professor of medicine emeritus at UC-San Francisco in the division of gastroenterology, comments frequently on alternatives to colonoscopy. KCBS in San Francisco recently interviewed him.
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Lisa Collier Cool
May 24, 2012 at 10:01 amExcellent post, Gary! Thanks for reminding people about the importance of colon cancer screening and highlighting the different options. The statistic about an estimated 19,000 lives potentially being saved if everyone over 50 was screened is very powerful and I hope it will encourage some of the blog readers who may have put off being screened to make that important appointment.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like