The Colon Cancer Detection Industry - It Goes Unquestioned

[MineralMan]

This year, at my annual Geezer Inspection, my primary care doctor did an end-around on me. He knows I don't think a colonoscopy is something I need. So, he just sent me to the clinic's lab each year for an occult blood stool sample test. He's been pretty good about accepting my preferences.

There is zero family history of colon cancer in my extended family. My excretory habits are dead-on normal. So, I've just believed it would be a waste of time for me.

This, year, though, he ordered a Cologuard test. The box came via UPS. I'm a pretty compliant guy, so I went ahead and did it. And, wouldn't you know, it came back positive. So, I went ahead and got the colonoscopy. I was surprised when I did the nasty prep and showed up for it, and the when the doctor administering it said, "We rarely do colonoscopies for people over 75 years of age, but your doctor has ordered it." Again, I'm a compliant guy, so I said, "OK, just go ahead. I've already done the prep, so you might as well."

When I woke up after the procedure, the doctor came in and said, "Well, I didn't find even a single polyp in there, or anything else that was abnormal at all. You don't need to repeat this, ever."

Much ado about nothing. My normal routine was disrupted for three days. Not a huge deal, but I don't normally fast. I don't normally willingly consume things that cause the effects of that prep, nor do I usually have a procedure that requires sedation. None of this has any out-of-pocket cost to me. It's covered by my Medicare Advantage plan. Still...

I haven't done any research on the statistics around colonoscopies, nor have I looked into the statistics regarding false positive and negative Cologuard results. Cologaurd ads mention both false positive and negative results, though. I didn't know that colonoscopies are not usually given to people over 75 years old. I'm almost 78, and even if they had found something suspicious, they probably wouldn't have done surgery. So, I have to ask myself why I did this in the first place.

It is an industry now. TV Ads run frequently recommending colonoscopies. More ads run for Cologuard. All the time. Every day, really. Even if you don't pay out-of-pocket, those who perform colonoscopies, along with the company that offers Cologuard, get paid. Every time one is done. There was a team of five people involved with my colonoscopy. They all get paid. There is a cost for all of those tests and procedures.

The conventional wisdom now is that we all need a colonoscopy or four during our post-45 years. I wonder. That conventional wisdom has come from all those TV ads and PSAs. I'm not going to spend a bunch of time researching the actual statistics, though. That wouldn't make any difference. But, I wonder...

[CurtEastPoint]

1. my Dad used to grouse about docs/medical stuff: "It's a GD racket." I used to think he was a crank.

Now I believe him. I am 73 and a lot of that shit is just to make money

[MineralMan]

3. Yeah. I hear you.

I see my doctor once a year, and that's it. There's an annual wellness check for old geezers like me. I finally caught COVID, but I've had all of the vaccinations, so I just took Paxlovid and rested for three days. I didn't see any doctor for that, but just talked to one on the phone, who prescribed the Paxlovid.

I'm embarrassingly healthy, I guess, for being 75. Surprisingly so, really. I've already lived my three score and ten. I walk, I talk, I eat, I use the toilet in a normal way.

If that were different, I'd see a doctor. But it's not.

Anyway, I went through with it, and got a confirmation that I'm OK. That's good, I suppose.

[Walleye]

2. I can commiserate with you on this. My colonoscopy is due this month

I’m 74, I think I had a polyp on the last one, but my mom died of colon cancer and so did her mother so I’m stuck taking this test. If it prevents what happened to my mom it’s worth it to me, but for you I can see why you’re a little miffed about it. I really think the doctors are just trying to keep you alive. The pharmaceutical companies I’m not sure about

[MineralMan]

5. Well, I went ahead and did it.

I'm just wondering, though...

[Walleye]

8. At least if they find a polyp they can remove it before it becomes a problem, I think

Hey you’re taking care of your health, good job.It is a hell of an ordeal. My mom died when I was 40 and I’ve been getting one every five years since then.

[MineralMan]

11. Yeah. The older I get, the less I care, really.

Anyhow...

[Walleye]

15. I'm pretty much getting to that point now, especially when it comes to replacing missing teeth

[womanofthehills]

120. I've never had one

As long as everything is normal I’m not going there.

[MineralMan]

122. Yeah, I wouldn't have either,

except for that false positive from Cologuard. At almost 78, I'm not all that concerned about colon cancer in myself. That won't be what kills me.

[wnylib]

68. My mother had colon cancer.

She had surgery and chemo, went through 5 years of remission, and was considered "cured." That was when she was in her 60s. She lived to be 90.

I have had 3 colonoscopies and all came out normal. The last one was about 11 years ago. My doc ordered a Cologuard for me on my last visit. I keep forgetting to collect and send a sample.

It's not something I worry about, despite my mother's history. She had diverticulitis bouts frequently many years before she developed colon cancer, and often had digestive problems. From what I've read, people who experience chronic diverticulitis are at higher risk of developing colon cancer. I've never had diverticulitis or diverticulosis. My bowel habits are regular. My colonoscopies have been normal. I'm 73. Seems it would have shown up by now.

But I guess I should follow through with the Cologuard.

[The Blue Flower]

4. I put it off for 20+ years

The colonoscopy sounded like a total pain in the bu**. Docs started advising me to do it at age 50. I finally had one last year and I was right. But a GI doctor who's a family friend said the Cologuard is a total waste of time. You can get false positives and false negatives. It tells you nothing useful. Best to skip it and just do the colonoscopy. The insurance cos. are paying for the cologuard. That company spends a fortune on advertising a useless product and rakes in even more from people who buy into the commercials.

[sinkingfeeling]

6. I'm 75 and have refused both for years. I'm a throat cancer survivor and whatever else goes

south, I'm probably not going to have a lot of treatments.

Along the same lines, I just refused a total knee replacement. The orthopedic doctor never went over at the MRI or x-rays with me to show me the extent of the problem. He just immediately said I needed a replacement before he even examined my knee. It felt like a total push to surgery. I will seek a second opinion if my knee pain acts up again.

[MineralMan]

12. Seems wise to me.

[malaise]

81. A friend has been in hospital for more than three weeks

with kidney failure - he’s nearly 85. I’d opt for hospice or go home and die in peace.
I don’t get it.

[MineralMan]

82. I would do the same.

I do not fear the end of life.

[malaise]

87. Same here

Some folks think they can stay forever - I'm not staying around for the bedsores when it is obvious that nothing works anymore and there is no short or long term fix..

[whathehell]

48. Colon Cancer is the 2nd leading cause of cancer death..

I'm 73 years old. Pre-cancerous polyps were found during the colonoscopy I underwent at age 50, so I'm glad that I did. I'd be long dead now if I hadn't.

[Tetrachloride]

7. A classmate died age 54 of CC.

[MineralMan]

14. I'm not saying that colon cancer is not a real problem.

Not at all. I'm almost 78 years old, though. That's different. I did it anyhow, but that hasn't changed my attitude.

[Tetrachloride]

26. yep. i'm halfway in the various opinions

[whathehell]

49. It's the 2nd leading cause of cancer death.

It's surpassesed only by lung cancer.

[shrike3]

102. An acquaintance died at 46.

Perfectly healthy, no problems at all, no symptoms until it was too late. They lasted a year after diagnosis.

[TexasTowelie]

9. I need to get a colonoscopy;

however, the biggest problem for me is to find someone to wait while I have the procedure. I admit that the prep and then the gradual easing back into a normal diet is also exhausting.

[MineralMan]

17. Yeah, that can be an issue.

Fortunately, I've sat in many medical facilities to take my wife home, so she didn't mind waiting for me this once.

[BlackSkimmer]

109. Yeah, I've sat and waited for more than a few friends more than once.

And of course for my mom, the one time she did it lol. Like you practically forced into it by her doc.

Around 72 I think. No problems, and she never did it again.

I'm not in the least inclined to do this particular test.

[Demobrat]

35. Where I live

there’s a service that is recommended by the clinic. It’s more than an Uber but not outrageous.

[TexasTowelie]

64. See post #62 below. nt

[Scrivener7]

78. I have a family history and have polyps removed every three years since I was in

my 30s. But I have never eased back into normal eating after a colonoscopy. Are we supposed to do that? I usually go to a diner after and have a lot of coffee and a cheeseburger.

[whathehell]

53. I believe another person can simply be there to take

you home, if that helps.

Please find a way to get the procedure, Texas Towlie. I'm 73 years old, and had I not followed standard medical advice and got one at age 50, I'd be be long dead.

[TexasTowelie]

62. I've already talked with my physician and someone has to sit and wait while the procedure is done.

There might be a volunteer group in my area according to the physicians, but none of the people at the health clinic actually knew how to contact them.

[whathehell]

73. Okay.

Does the volunteer group have a name?..If so, you could probably Google the name and get their address and/or phone number...I really hope you make it happen, as you definitely do NOT want to gamble on your health. Were I in your situation and all else failed, I'd be willing to pay someone to accompany me. I'd even offer to take you, if I lived in your area.

[TexasTowelie]

92. They couldn't remember the name at the physician's office.

I'm going to see another medical provider within the next week and I have one or two other sources that might have a clue. However, I moved here about four years ago and didn't develop any friendships prior to COVID and the amputation of my leg. I'm still waiting to find out the results of some other tests so I have a bit of time to get an appointment made.

[whathehell]

100. Well, it's good you've got some time..

and other possibilities. I wish you the best.

[Retrograde]

80. Interesting- the last few times

my husband had them I told the staff that i’d be out having a coffee or grocery shopping or sitting outdoors- as long as they had a way to contact me it was fine with them. For that matter, when i recently had eye surgery at the same hospital they told Mr Retrograde to go home and wait for them to call

[70sEraVet]

60. I was still working back when my doc scheduled me for my first colonoscopy.

I asked him if he could schedule it in the morning, because i worked 2nd shift and that way i could still get in a full day's work. He said ok.
A few days later, a nurse called, and told me to be sure and arrange someone to drive me home after the procedure. I said, "Drive me home? I'm going to work!"
It was a while before she stopped laughing, then explained, "Honey, you are NOT going to go to work that day, believe me!"
I still don't know if my doctor just didnt pay any attention to what i said, or if he just figured that I'd find out what a colonoscopy is.

[mercuryblues]

134. Just tell a friends

You want to get wasted and you're looking for a designated driver.

[IcyPeas]

135. there is non-sedation colonoscopy:

After a sedation-free colonoscopy, you can resume normal activities right away — you can drive, run errands and generally get on with your day.

The second benefit is increased safety. Overall, the sedatives used for colonoscopies are very safe, but there is a small risk of side effects, such as drops in blood pressure, breathing problems, vomiting and prolonged sedation. These are avoided by having a sedation-free colonoscopy.

The third benefit is lower cost. Sedation adds to the procedure's expense. This may be helpful for patients paying out of pocket due to a high-deductible health plan or lack of health insurance.

Is a sedation-free colonoscopy painful or uncomfortable?
Most patients report little or no discomfort during the procedure. You can request sedation during the procedure if you change your mind and feel you need it, although it has been my experience that this seldom occurs.

more:

https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/benefits-of-sedation-free-colonoscopy

[TexasTowelie]

136. The issue becomes whether a GE can be found that is willing to do the procedure.

The hospital that I would have the procedure done is a teaching hospital affiliated with Texas A&M med school. I have my doubts about whether they would do that procedure at the hospital or if they would send me into Houston instead which creates even more problems. I'm not doing anything until I get the results from my other tests anyway.

[former9thward]

10. I agree with you 100%

I am 72 and about four years ago had a Cologuard. It was positive. I was urged to get a colonoscopy but ignored it since I have no family history and no issues. Then about two years ago I had another Cologuard and again positive. I wanted to ignore it but a couple of friends urged me to get a colonoscopy so I did. This was my first colonoscopy and it was completely clean and the Dr. said I never needed to get another one for the rest of my life.

I am not saying Cologuard is bad or colonoscopies are not needed but the I think the media over does it.

[MineralMan]

16. Yes, exactly. Your experience and mine are the same.

Do I feel better after that colonoscopy. I don't know. I wasn't worried about it before, during, nor after. I was quite sure I didn't have a problem.

[FreeState]

34. I dont think the media overdoes it

In fact I fear people fall for woo and miss information about nutrition that is rampant online and in the US and think if they eat well they never get cancer.

I get a colonoscopy every yet and will until I’m in my 70s due to genetic risks (Lynch Syndrome). Prevention is vital and any downplaying it does real harm.

[Abnredleg]

13. My MIL had a Cologuard test that came back negative

She was then diagnosed with Stage 4 colon cancer six months later - she lasted eight months. Always get the colonoscopy. Colon cancer rates are increasing, particularly among younger people, which is why they now recommend getting your first one at age 45.

[MineralMan]

18. Colon cancer does happen.

However, like my colonoscopy provider said, they are not usually done on people over 75.

[thatdemguy]

19. My wifes best friends mother

Is down to a few months to live due to CC. No family history, refused the tests. She felt bad a few months ago and went to the doc, she is now in home hospice care with her family watching her die, slowly.

I plan on getting my first test this year at age 51.

[1WorldHope]

20. I hope you don't have to pay for the colonoscopy...

I'm under the impression that it is only considered preventive if you don't have a positive Colo guard test. Therefore, INS co.'s won't treat it as preventative. I hope I'm wrong. But glad you are clear too.

[DownriverDem]

66. Insurance companies

do not use Colo-guard when covering colonoscopies.

[forthemiddle]

71. You are correct

I do medical coding for colonoscopies, and if it is done because of a positive cologuard it is no longer considered a screening procedure.

[milestogo]

21. I've had a colonoscopy and I've done cologard.

I also worked at the company that creates cologard and is inventing other cancer screening tools.

A colonoscopy is invasive, uncomfortable, and expensive. Patient has to take at least a day off work and endure a miserable prep. If there's no family history and you have a clean colonoscopy, the cologard screening should be enough to protect you after that.

The price of colonoscopy is around $6K vs $600 for cologard. It makes sense to use a cheaper test as a screening for most people.

I'm told the colon doesn't change very much from year to year. So its not like people need frequent screenings.

The limitation with cologard is false positives: The purported rate is 6 percent in those aged 50 to 65. However, DNA methylation occurs during the normal aging process, and thus causes more false positives in people above the age of 65 (a 13 percent false positive rate).

Its hard to say no to a cancer screening. I'm glad you got through it and that you never have to do it again.

[zuul]

36. This is good information. Thank you.

[TxGuitar]

84. Agree completely

My wife and I did cologard this year. Happy to have no invasive screenings. Even if my wife had to send in a second sample. Seems she didn't send enough poop.

[Jacson6]

133. I had a colonoscopy and learned how to avoid the horrible preperation

Three days before I had to do the preparation I had eaten nothing but soup for those days. The prep wasn't so bad. I had a family member that had stage 4 colon cancer at 40 years old and he survived it.

[Silent Type]

22. One reason I fear we will never have AFFORDABLE healthcare for everyone. The industry is too profit

oriented, which impacts the standard of care.

With that said, I think colonoscopies are probably a good idea for most people.

[Delmette2.0]

23. I was 67 when I was diagnosed with colon cancer.

My PA knew I was leary of a colonoscopy so she ordered a CT first. There it was, an obstruction about 1/2 an inch wide. I had the colonoscopy to confirm the diagnosis and had surgery the next week. It was cancer but it was contained. I am 3 1/2 years into my checkups and so far I am clear.

My son is 43 and he will get his first colonoscopy at 45.

[JCMach1]

24. Same thing this last year at 55 . Positive cologuard

And completely clean colonoscopy.

[pinkstarburst]

27. Colonoscopies are an important screening

Colon cancer is occurring now in younger and younger patients. Chadewick Boseman (Black Panther) died of it at 43. He was first diagnosed at 39.

Telling people to skip important screenings just because you happened to make it to 77 without anything happening to you is irresponsible.

[MineralMan]

30. You know, I'm not telling anyone not to get screened.

I never said that. I said I wonder about the whole Cologuard and colonoscopy thing. Wondering is not telling anyone anything.

I wouldn't do that. I got the screening, myself. People should ask their doctor about it.

[tinrobot]

86. You certainly made strong arguments against screening.

But... you didn't "tell anyone" not to get screened.

As someone who has lost people to colon cancer, I guess those subtleties are lost on me.

It's one of the most preventable cancers out there - if you get screened.

[zuul]

37. +1

[Auggie]

39. +1,000,000

[Sky Jewels]

52. Yep. They found a tiny polyp in me when I was 50.

Who knows if Cologuard would have picked up on it. The biopsy showed that it was the pre-cancerous type. If I hadn't had that colonoscopy, it's likely I would have eventually had full-blown cancer. That colonoscopy wasn't a big deal and it paid off exponentially in years of health, as well as saving me a huge amount of stress, fear, time, and money.

[malaise]

101. Maybe people should focus way more on their diet

while they are young

[Sky Jewels]

131. Yes, avoiding processed and cured meats is a huge one.

Bacon, "lunch" meat, jerky, etc. -- all very bad for the colon.

I center my diet on vegetables, which I absolutely love (luckily!). My dad was prone to polyps, and I had a small pre-cancerous one removed when I was 50 (the next colonoscopy at age 55 was clean), so I'm extra careful.

[pinkstarburst]

138. I do not eat processed or cured meat

and I had a precancerous polyp removed at age 40. I agree that eating a healthy diet is important for everyone, in addition to doing the screenings doctors recommend.

[malaise]

139. I only eat seafood and bird meat

I gave up red meat and pork in 1979.
I eat lots of fruit and veggies but I do have a sweet tooth and enjoy all sorts of desserts and chocolates now and then. I. Avoid soaps but make all sorts of fruit drinks with honey, brown sugar or molasses.
I like a glass of wine or a cold beer now and then.

[moonscape]

28. I have a Cologuard test in my

bouse somewhere that came in the mail by surprise order from my doc.

I had told her I would not have a colonoscopy because there was no family history but more, that I’m already on chemo for one cancer and I don’t intend to start treating two. If I have/get colon cancer, then will consider my time is up. I’m 72.

A close friend had a colonoscopy when she was mid 70’s (now 80) and had a benign polyp. They removed it but caused an anal fissure. She is a healthy hiker/biker, takes not a single med, vegan, etc but … she now gets intermittent surprise fecal oozing without notice.

No colonoscopy for me, so no point to Cologuard.

[Liberty Belle]

29. A routine colonoscopy killed my mother in law, 75,by puncturing her colon.

I refuse to get one unless I develop symptoms. Our family has a history of longevity, except those who got Alzheimer's,and if I get that, nothing else will matter.

Another acquaintance wound up in a wheelchair from the same thing that happened to my mother-in-law.

I'm sure they save some lives, and if I was in a high risk category I'd think differently.

[MiniMe]

94. I think that is why they don't recommend colonoscopy after 70

Of course, they did that with my mother, and her CC came out when she was 82. Because of my mother's CC and my grandmother had CC also, I am pretty good about getting colonoscopy.

[Igel]

31. My GP says the same: Get a colonoscopy.

Problem with tests is that they're often biased to give false positives. This is reasonable--you'd rather be safe than sorry, if 100% accuracy isn't available.

"Precautionary principle" is what's being applied. It's the basis for a lot of advocacy groups when it comes to medical and environmental or even business practices, as though it's cost neutral.

[Demobrat]

32. A dear friend has stage 3 colon cancer. He's 65.

The treatment is excruciating. He doesn’t know yet if he’ll be wearing a colostomy bag for the rest of his life. It’s most likely.

When he called to tell me the news he said “If I had had a colonoscopy 5 years ago we wouldn’t be having this conversation”.

Possibly the most heartbreaking thing anyone has ever said to me.

Just saying.

[ProfessorGAC]

33. Their Own Website Acknowledges a 13% False Positive Rate

More than one in every 8 tests indicate something that doesn't exist.
That seems a ridiculously low efficacy rate, to me.

[FreeState]

41. It seems in the high range of the range most cancer screenings

The false positive rates in cancer screening can vary depending on the type of cancer and the specific screening test used.

Mammography (Breast Cancer):
The false positive rate for mammography can range from 5% to 15%. This means that in some cases, the mammogram may indicate a potential abnormality that requires further testing, but it turns out not to be cancer.

Prostate-Specific Antigen (PSA) Test (Prostate Cancer):
The false positive rate for PSA testing is estimated to be around 75% to 80%. Elevated PSA levels can be caused by conditions other than prostate cancer, such as benign prostatic hyperplasia (BPH) or prostate inflammation.

Pap Smear (Cervical Cancer):
The false positive rate for Pap smears is generally low, ranging from 1% to 8%. False positives can occur due to factors like inflammation, infection, or non-cancerous changes in cervical cells.

Colonoscopy (Colorectal Cancer):
The false positive rate for colonoscopy is relatively low, estimated to be less than 10%. False positives can occur if the colonoscopy detects polyps or abnormal tissue that require further examination or biopsy.

[Scrivener7]

83. Considering that before Cologard the ONLY screening was a colonoscopy, this

vastly reduces the incidence of people who have to get colonoscopies who didn't strictly need them.

I would have been dead by 40 without colonoscopies, so I am eternally grateful they exist and I am religious about getting one every three years.

They are really not that big of a deal. Especially considering the possible alternative.

[FreeState]

96. I'm there with you

Extremely thankful for colonoscopies (I get them every year - Lynch Syndrome). One of about 12 screenings that help keep me alive

[Scrivener7]

99. They tested me for that this year bc of the family history and my personal

history. I don't have it though.

Maybe because I have had so many, I find people's reactions to colonoscopies puzzling. It's definitely a pain in the neck, but it isn't all that big of a deal.

I wonder if people know to do the prep with Gatorade to keep their electrolytes up. Maybe that is why people find it so awful. Before I knew to do that, the prep made me feel pretty sick. Now it's just a necessary discomfort for a few hours every three years

Glad they were able to diagnose you so you can take care of yourself. Good luck with it.

[TNNurse]

38. Had a colonoscopy at 69,

it was clear. Doc said "See you in 10 years". I responded "Maybe you will and maybe you won't". He laughed.

If there are no issues that urge me to have one sooner, at 79, I will just not go. Not interested in any treatments at that age.

[FreeState]

43. My family has genetics that lead to colon cancer

My Dads doctor stopped for him at 78 (he’s almost 90 now). It takes on average 5-10 years to develop so it makes little sense to test within 10 years of average lifespan.

[TNNurse]

45. I have survived breast cancer,

my father died at 50, my mother at 76....I do not expect longevity. My siblings are 76 and 79 and both have health issues as well. Just going to focus on what I can enjoy now.

Oh, and working to elect Democrats!!!!

[ARPad95]

40. Colon Cancer Incidence and Mortality by Age group, New York State, 2016-2020

https://www.health.ny.gov/statistics/cancer/registry/table6/tb6colonnys.htm

I have had 2 colonoscopies (at age 50 and 55) and they had such adverse effects on me that I decided not to subject myself to another one. Per the chart above and my long-term healthy lifestyle, it's highly unlikely I will have colon cancer.

My elevated risk is skin cancer/melanoma so that's why I see my dermatologist annually for a full body check and to treat or remove anything suspicious.

So far so good and I'm almost 63.

[wackadoo wabbit]

108. What were the adverse effects you experienced?

Was it to the anesthesia (they always give me too much, and I wind up urping my guts out when I wake up), or to the colonoscopies themselves? Intestinal perforation is always a risk.

[ARPad95]

126. The colonoscopy procedures did not cause issues except for the second one when I hoped to have

conscious sedation so I could watch it on the monitor. That ended quickly when I felt pain the moment the probe (or whatever it's called) was inserted and hit the first bend in my colon. Full sedation for me!

I have non-insulin dependent diabetes and hypertension. The first colonoscopy prep left me so dehydrated that when it came time for the procedure in the hospital where I was going to put under general anesthesia, the nurses couldn't find a vein to insert the IV needle. They tried three times in one arm, a fourth time in my other arm and finally went through the back of my hand. I felt like a literal pin cushion! I had pain the entire time the needle was in and had a fiery red streak to match.

The second colonoscopy prep caused my blood pressure to go off the chart (the one that determines if you're good to undergo the actual procedure). The procedure was delayed for an inordinate amount of time while the anesthesiologist kept coming to my "cubicle" asking the nurses for my latest blood pressure readings. He also asked me various questions about my heart health history. (I truly felt relaxed and not stressed at all, but my heart has a mind of its own apparently.) My husband was supposed to be able to sit with me during this waiting period, but he was never called back to do so. When I was finally wheeled into the procedure room, I checked the monitor before being put under anesthesia and my blood pressure reading was at either 184/90 or 180/94. I have no idea how high it got while I was waiting. Several months before, it had been at 200/110 as I sat fully relaxed in a doctor's office.

So I weighed the stress the colonoscopy prep and procedure place on my heart with the chance of me ever being diagnosed with colon cancer and decided not to put myself through it again now that I'm in my 60s trying to avoid any type of stress if at all possible.

[Chautauquas]

42. I regret taking the cologuard test. Here's why

I took the cologuard test and had a positive result. My doctor recommended I get a colonoscopy, so I called my provider and asked if they would cover the colonoscopy and they said no. Reason given was that the cologuard test was covered because it was deemed a preventative measure but the colonoscopy would be deemed a diagnostic test. They also said the colonoscopy would have been covered - if I hadn't done the cologuard test. In retrospect I wish I had skipped the cologuard and went ahead with the colonoscopy.

[FreeState]

46. Obama Care was supposed to fix this

But the insurance companies have found work around. I get one yearly, preventative. I shouldn’t pay anything but I end up paying $700 for the colonoscopy and an additional $700 if any polyps come back precancerous (which they always do).

Then takes about three years to get my money back, I always get it back, but it takes three years.

[misanthrope]

98. You mean a plan with its roots in the Heritage Foundation

didn't fix it? What a surprise.

[Old Crank]

44. Had a friend who put of the Colonoscopy

For him it was not a good choice. I put mine off until 57. Now I've had 2. next one due at 77. Not sure what the Europeans think about the age issue. CDC says 75, but talk to you docter from 75-85 for other less invasive testing. I think I would keep taking them if I had a history in the family, but no for me.
Here is the CDC link

https://www.cdc.gov/cancer/colorectal/basic_info/screening/index.htm#:~:text=Regular%20screening%2C%20beginning%20at%20age,to%20their%20doctor%20about%20screening.

[MurrayDelph]

47. Had my first one weeks after turning 50

The GI doc had a speech he liked to give, that I interrupted.
GI: Your doctor has requested this procedure...
Me: Hold it there. He didn't request it, I did! My sister had malignant polyps, but they were caught early-enough for her to die of something else (Crohn's complications). My dad had malignant polyps, but were caught early-enough for him to die of something else. When the treatment is early detection, as far as I'm concerned, you can poke me, prod me, bleed me, hell give me a stick to pee on if it'll help.

My wife has a condition that could have been fatal, but is easily treated with an expensive enzyme treatment. But she gets a colonoscopy every three years.

Seven years ago I had a mystery blockage they were afraid was late-onset Crohn's; a colonoscopy showed that it wasn't and it cleared up on it's own, so they told me to come back in three years. When I came back in three years, everything was fine and they told me to come back in five.

I'm four years since my last colonoscopy, and am trying to get my next one a year early. A 72-year-old friend of mine has Stage 4 colon cancer and was staying on schedule for colonoscopies. So I'd rather err on sooner.

[Major Nikon]

50. I'd probably be dead by now had it not been for my first one

I started at 45 due to a family history. Doc found and removed a few polyps that he said probably would have turned into cancer in 10 years. Have known a couple that died from colon cancer and another that almost did. All of them my age.

[bringthePaine]

51. thx for genuine perspective! always smelled a bit of " racket" to me...

[bluescribbler]

54. I have two friends whose husbands died from colon cancer.

Both men were in their thirties, and in spite of all their symptoms, and in at least one case, family history, doctors refused to order colonoscopies or other relevant tests because the men were "too young for colon cancer." By the time they were diagnosed, it was too late.

[Sky Jewels]

55. Goddamn. That's so sad ... and infuriating.

Our fucking for-profit system kills untold thousands of people every year.

Why do we put up with it? (I mean that in the most general sense; I know most people on DU want universal public health care.)

[retread]

56. I have had 5 clear tests since I turned 50. My unanswered question is:

Is there any evidence that a routine colonoscopy is any more accurate than a fecal occult blood test?

[MineralMan]

124. I don't know. I've had one of those simple tests every

year since I was 55. Always negative. For some reason, my doc ordered up the Cologuard at my most recent Medicare Wellness Visit. I don't know why. I'll ask him next year during that visit, because that's probably going to be the next time I see him, as usual.

[carpetbagger]

57. I deal with this every day.

Part of my job (because everyone else quit) is as a geriatric primary care doctor. What you're saying is in line with my general reasoning and the USPSTF guidelines. 76-85 is individualized, based on family history, prior polyps, and life expectancy. The data on colon cancer screening at peak benefit (50-70) is rock solid, and even at the margins of age recs still better than some of the other screening we do.

At my work, I am pressured to close out computer reminders on colon cancer screening in very old people which requires me to bring up the subject even when I'm going to discourage it. Depending on office volume, I can imagine for some clinicians the easiest answer in a consumption-driven system is to order.

[40RatRod]

58. I had been told I didn't need any more but turned out...

...I required a double colon resection and radiation. Glad I kept having them.

[Scrivener7]

89. Wow. I'm sorry. Can I ask what age you were when that happened?

[40RatRod]

116. 1998

1998. Still get one every 3-4 years

[jaxexpat]

59. Oh, I got a colonoscopy story. My last one, about 6 months ago.......

Just before they put me out (that's when I get to ask if "I'll be able to play the piano when I come to" and they say, "I don't see why not" and I say, "great, I've always wanted to play the piano" and they say, "start counting backwards now&quot they asked if my sleep apnea was severe or normal. I started to say "severe" when they gassed me. That afternoon I discover they'd intubated me, just like a full blown covid victim. I had been violated and had bruises and a terribly sore throat to prove it. When I called their office the next day, their "office manager" was very apologetic and affectatious in her sympathy. I thought of Susan Collins, the Senator of Maine. Now I know how she should gain her enlightenment.

So whadduyouknow? Not much, you? Don't you terribly miss Michael Feldman's take on PBS/PRI Saturdays?

[MurrayDelph]

90. Your story reminded me

of a time 20 years ago, when a bunch of us were getting together for dinner and one friend commented that he was starved as he hadn't had anything to eat that day due to having had a colonoscopy. We asked about the results and found the only thing wrong with him was newly-diagnosed sleep apnea. My question was "How far up did they shove that camera?"

[jaxexpat]

91. With that query, I'm afraid you went a bit far. Hmmmm?

[Coventina]

61. Probably zero people with see this so far downthread, but still.....

I just had to post this:

[niyad]

128. That is hysterically funny!

[caraher]

63. I did Cologuard last year

It came back positive and I had a colonoscopy. They removed a couple polyps and said come back in 10 years (when I'll be bearing 70).

I was a bit surprised to learn how high the false positive rate is. But I also feel good about not just having a colonoscopy as a matter of course, even if the Cologuard screen isn't great.

[AverageOldGuy]

65. I'm 78

Never had a colonoscopy. Never will. My choice.

With my annual physical the doc gives me one of those collect-it-yourself-and-bring-it-in test kits. Always come back negative.

[llmart]

67. Interesting post

A few years ago the NY Times did several columns on how doctors are overprescribing biopsies for prostate cancer to any man over 50. The author said if a cancer is found they immediately want the patient to have surgery or radiation, both of which can have some very negative effects. I guess they figure they err on the side of caution because there is no way to determine if it's a slow growing cancer or not. I remember hearing that most men die with prostate cancer, not from it.

As someone who had a false positive from a mammogram when I was 52, who went ahead and had the surgical biopsy (that wasn't fun at all). It turned out to be a benign calcification. I started to wonder about whether surgery had been absolutely necessary. Later I was reading an article, also in the NY Times about how doctors were overprescribing surgical biopsies for spots they see on mammograms. At one point the studies and the cancer society were saying that if you don't have breast cancer by 70 you no longer need regular mammograms. The same was true for pap smears. The guidelines change back and forth so much, one can't keep up.

I'm 74 and unless I have noticed any major changes in my body or health, I will not be getting every test a doctor orders or some newsperson says I should be having. I have never had a colonoscopy, stopped having pap smears years ago. I'm fortunate that my doctor does not badger me about my stance. She just said, "I'm not going to order every test in the book. You are the boss of your body and life. Besides, I've been a doctor for many years and I don't need any more money."

I read a book by Barbara Ehrenreich called "Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Killing Ourselves to Live Longer". You might find it interesting.

[BlackSkimmer]

110. I loved Ehrenreich.

Welcome to Cancerland is another of her great articles regarding the whole experience of being ill in America.

[llmart]

112. I have not read that one...

but I agree that I've loved every single book and article of hers that I've read. I will put that one on my "to read" list. Thanks for the recommendation.

[Silent Type]

69. If President Biden thinks it is a good idea, so do I.

[BlackSkimmer]

75. Lol, I like President Biden, but I don't make my personal health decisions based on his.

Or any other public figure.

[usedtobedemgurl]

70. I had the same kit...

It came back positive. In the hospital, I was clean. I think it is a farce.

[Mosby]

72. I'm supposed to get one but I don't want to.

So here's the thing, why do you have to fast and take a bunch of laxatives? My wife kept puking from the laxatives. Why can't you just give yourself a couple enemas? Do they intubate you? Is that why?

[MineralMan]

76. No intubation, as far as I know.

Last edited Sun Jun 18, 2023, 06:06 PM - Edit history (1)

They look at your entire colon. My report had images of the valve that is between the small intestine and the colon. I think that's there to show that the scoped the entire colon.

They can't see it if there's stuff in there. An enema won't do that. They also inflate your colon to open it ip for viewing. An empty colon collapses.

[tinrobot]

93. They don't intubate. Usually just a mild sedative/anaesthesia

Just enough so you don't feel it. You're out for maybe an hour or two.

Enemas don't clean out the upper parts of the colon, thus the top-down approach.

And yes, the prep sucks, but it's only one icky day. Colon cancer is way, way worse. Get tested.

[carpetbagger]

95. They need to be able to see.

Enemas will only clean out the rectum. They go six feet up your innards, and if you don't clean out completely they'll miss half or more of the cancers and polyps. It's like sending a recovery team into muddy water.

[Sky Jewels]

132. They have to thoroughly clean out your "tube," basically, so they can take a close look.

I'd highly recommend getting a colonoscopy. They're not a big deal, and they prevent a ton of colon cancer. I would likely have full-blown cancer by now if I hadn't had a pre-cancerous polyp identified and removed when I was 50.

[doc03]

74. I have had 3 or 4 Colonoscopies and they found nothing. I think I am

due in 5 years at 80. I have known three people that had their colon punctured and one died from it. I am not doing another unless I have symptoms that make it necessary.
I am doc03 but not a doctor so don't follow my advice.

[Scrivener7]

77. Colon cancer is a horrible way to die. It is also a commonly occurring cancer.

Colon screenings and, if needed, colonoscopies prevent suffering and death from colon cancer.

[shrike3]

104. Yes, it is a horrible way to die. I've had two acquaintances, one of whom was quite young

pass from the disease, and the younger one had a very hard time. Was up screaming most nights. Hospice did its best. Fast, drink the prep and get it done.

[Scrivener7]

106. That is awful. I'm so sorry.

[shrike3]

107. Thank you

[Lars39]

79. Depends on what you want to put your loved ones through, I guess.

Been there, done that, and for weeks it took quite a few people round the clock to take care of the patient.

[tinrobot]

85. Wish there had been a "colon cancer detection industry" for my Dad (who died of it at 54.)

This was way back in the early 90's - before there was regular testing. His untimely death could have totally been prevented. I missed out on a lot of good years with him because of that.

So, for the sake of my kids I get the procedure -- every 5 years.

In a half dozen procedures, I've had one or two polyps, but mostly negative results.

Testing is better than not knowing.

[shrike3]

103. So sorry. An acquaintance of mine died at 46.

Suffered a great deal during the treatment and the dying process. Wouldn't wish it on anybody.

[cksmithy]

97. My neighbor, whose doctor never had her

get a colonoscopy, until she asked for one in her mid 70's, finally had the procedure. She was diagnosed with stage 3 colon cancer and had 12 inches of her intestines removed. They saw cancer on her liver but decided to just watch it. She finally went to Stanford Medical Center, had more surgery, had her chemo and cancer treatments coordinated with our Central Valley doctors. She goes to Stanford for all medical care now. Stanford has also removed half of her thyroid because of cancer nodules. She didn't have a family history of any cancer. She is doing fine now, but has had several rough years. I had one at 50 and another on at 71 (because of my neighbor) and was told by doctor who did the procedure, I never have to get another one. My sister, who is five years younger than me, who suffered for years with abdominal pains, had emergency diverticulitis surgery, diagnosed at the corner walk in doctor office in her late 50's. She, also had 12 inches, of intestine removed, and is now supposed to get a colonoscopy every five years. You just don't know. I am glad my friend finally got a colonoscopy when she did, or else she would be dead.

[neverforget]

105. I had my first colonoscopy last year. They found 3 polyps one of which was 18mm. That's pretty damn

big. Anyway, they all came back clean but I have to have another colonoscopy this year to make sure they got it all and because my family has a history of colon cancer.

[Vinca]

111. My primary care provider told me that while Cologuard seems like a great idea, it often

comes back positive and, when it does, some insurance companies will refuse to pay for the ensuing colonoscopy that's necessary. It's just another moneymaker IMO.

[Johnny2X2X]

113. LOL at people thinking colonoscopies are profit driven

It's not a high dollar procedure and it's not something doctors are thinking about doing to make money. It's one of those screenings that there is a little debate on when it should be done and when it is most useful. People over a certain age being told they don't need them is basically just a doctor saying, even if we find something, colon cancer is so slow moving that you'll probably die of something else first because you're so old.

Not everything is big coprorations trying to make money, colonoscopies are simple, low tech, and non surgical, they aren't major revenue sources for any clinic. They save lives and save you having to endure expensive and devastating cancer treatment later in your life, the type of treatment that is actually profitable for clinics. If doctors were priarily concerned about money, they screen no one for colon cancer, because the cancer treatments later in bring in 100 time the revenue of colonoscopies.

They found 2 small polyps during mine that were easily excised, labs determined they were benign but would have had around a 10% chance of developing into cancer within the next decade. So instead of a 1 in 10 chance of getting colon cancer, the screening now has me at a 1 in 100 chance roughly.

[MineralMan]

121. They aren't?

Then, I wonder why a doctor would do them all day long as his main job. I wonder that for other reasons, but I'm guessing they are profitable, or we wouldn't see so many of them being performed.

Beyond that, Exact Sciences, the company that does Cologuard, processes many, many of their kits every week. When I took mine in to the local UPS office to send it off, the UPS store, a small one, had a separate place to put them. A big bag holder on a frame. I dropped mine in there about 10 AM on a Monday. The bag was almost full already. There must have been at least 20 of them already in there. I'm betting they have more big bags for them in the back, and that they change those bags more than once each day.

Now, think about all of the UPS stores around the country, each sending off scores of those tests on a daily basis. Oh, there's profit it in, I guarantee.

I'm not opposed to screenings like colonoscopies at all. They can help save lives, without any doubt. I wouldn't have gotten one, because I am a very low risk for colon cancer. I got one, only because of that false positive Cologuard test. If you are over 65, the percentage of false positives is way too high, it seems to me.

[Bettie]

114. We have a for-profit health system

The point is to generate income for the people who are invested in it.

Providing care is secondary to profit.

[Crataegus]

115. No Fishing

I told my doctor at the VA that there would be no fishing expeditions.

[MineralMan]

119. LOL!

[leftstreet]

123. DURec

[Mad_Machine76]

125. I was recommended for one last year at 46 y.o.

But when I tried to follow through I was told that my insurance (Anthem) wouldn’t cover it until I was 50+

[inthewind21]

127. The

entire medical profession has become a racket. My brother, stage 4 colon cancer, age 45, in renal failure, nothing more to be done so he's leaving the hospital for Hospice care. Before his release papers are processed they (meaning the hospital) came and got him to do one more kidney test. For what? Another 3k bill that's what. And you guessed it, his kidneys were still failing and there was still nothing to be done! I hate them all and trust none of them.

[LuckyCharms]

129. 5 colonoscopies so far with 16 pre-cancerous polyps removed in total.

I'm age 64.

Grateful that I had them done.

[MineralMan]

130. Clearly you need to keep doing that.

I had zero polyps and no other signs of trouble, at age 77. So, I won't be pursuing it any further. That's not really what I'm talking about, though. It's the system that's in place that I'm wondering about.

[Greybnk48]

137. I've had about 5 scopes so far (age 74) and so far I've had at least 1 pre-CA polyp every time.

I think I'm at a 3 year recall now. The prep is a drag, but not too bad when you consider the alternative. I worry most about a perforation during exam, but it's worth the risk in my case. And there is a history of colon cancer in my family, so I'm grateful they can catch it.

My husband just poops in the box.