The American Cancer Society (ACS) recommends a colonoscopy for everyone from the age of 50. The purpose of the screening procedure is to look for an existing colorectal cancer or signs of disease. Subsequent colonoscopy is recommended after 10-year intervals, if no problems are found. On the ACS website, the procedure is called “uncomfortable and invasive” and suggests “someone will take you home after the procedure”. Preparing for a colonoscopy requires “bowel cleaning” using a special diet and laxatives the day before the procedure. There are several potential complications associated with colonoscopy, including perforation, bleeding and death, again according to the American Cancer Society. The most common complication is perforation, which occurs roughly once in 1000 procedures, according to a 2009 review published in Genetics in Medicine. Death occurs every 12,500 procedures.
There are other, less invasive screening options for colorectal cancer, including virtual colonoscopy and stool tests, such as fecal immunological tests or fecal DNA. Of course, this is not what American doctors call the "gold standard." Colonoscopy is the gold standard.
A colonoscopy involves the insertion of a thin tubular instrument equipped with a small camera called a “colonoscope” (what else is a periscope?). This mini-dildo-like device is inserted into the rectum, where it is threaded through the entire colon. The colonoscope allows you to visually diagnose any incipient colorectal cancer and biopsy and eliminate suspicious lesions. If no damage is detected, suspicious or otherwise, two things happen before the device is removed while the patient is still in a state of sedation: 1) The doctor who performed the procedure was given enough time to get out of the city and start a new life under the government witness protection program; and 2) When the drugs are erased and the patient recovers completely, an experienced counselor says something like this to the patient: “Sorry, we haven’t found anything wrong with you. The colon is fine. Go back and look at us again for ten years.
No, I'm just joking - I did it, because here is a really awesome truth: the patient was ready for this very likely coincidence! And yet he went through it. He is not defiled by learning that it was in vain - he would be fine if he missed it all. All that he has is confidence that he does not have this particular disease or, most likely, it will soon appear. There are hundreds more others waiting for time. How many more tests should he know that he does not have one of them? In any case, this is what he really liked to talk about the results of the colonoscopy. At the moment, the patient not only should not have enough of the throat of the drugs that did this to him, but, on the contrary, he was programmed to be happy about all this. So he will probably say something like this: “Oh, thank you, I am very glad you people are the best.”
I have never paid much attention to what ACS or other medical organizations recommend for a single test. I was afraid of medical tests, inspections, preventive examinations, risk assessments and all such medical misconduct. It's too much. Such activity has been part of the medicalization of health for at least half a century. I learned about the problem as a health care plan, starting in the late 60s. I was immersed in medical policy and research for five years before moving on to my current role as a promoter. I have a PhD. in health and public policy. I have seen the near and personal reality and the wasteful, often dangerous consequences of our bloated, dysfunctional medical system. I wrote a lot about it.
The health problem caused by a medical problem has only worsened. In a recent report by the Institute for Progressive Policy (PPI), Peter Orsag, director of the Congressional Budget Office, quotes him to estimate that 5 percent of the country's gross domestic product — $ 700 billion a year — goes to tests and procedures that do not actually improve health outcomes. . He believes that "the unreasonably high cost of medical care in the United States is a deep-rooted problem that needs to be tackled at its root."
Doctors claim that colonoscopes are the gold standard for preventive medicine. Well, maybe, but who really needs a gold standard? Every over 50 every ten years? The jury is missing. Moreover, if you are 50 or more (or ever do it like this), you can do some checking to find out if the jury sentences about the colonoscopy are correct, as well as many other tests and procedures performed as usual.
In 2008, the American Cancer Society considered colonoscopy preferred. Medicare pays for colonoscopy, and the new Health Care Reform Act (PPACA) forces insurance companies to cover them.
However, I have reasons to resist this procedure, in addition to the general understanding that the medical system is replete with unnecessary checks, some of which can be dangerous to health and wealth. For example, a colonoscopy is three to four times more expensive than a simple test, sigmoidoscopy. This entails only a partial "probe", which lasts only a few minutes. No sedation, no need to take time off from exercise or work, no jug of laxatives or terrible emptying of the large intestine the night before, and perhaps no need for a family gastroenterologist or primary care doctor who can often perform this procedure.) Best of all, the risk of complications (infection, bleeding, urinary incontinence or, in the worst case, death from the script) is seven times less than for the Big Large C trial.
And here's the catch: the inventor of the colonoscopy, Al-Nogut, wrote an editorial at JAMA this summer, stating that he regrets that he invented the colonoscopy. Neugut said: "If today we were where we were in 1988, I would not become a colonoscopy based on current evidence."
According to one of them, the gold standard of preventive medicine can only be gold in terms of medical affairs.
All this is personal. I am almost 74 years old, and I have never had them. Many of my friends find it terrifying. My wife and my son chased me to do it. And one of my best comrades, a man who I hold in the highest esteem for half a dozen different reasons, pushed almost all the feet to convince me to turn into a large intestine, and decisive steps will be taken, including exposing myself as a false veteran prophet.
Charlie Chaplin said: "Life is a tragedy when it was seen in close-up, but a comedy in a long shot." Considering the pros and cons of this procedure, I continue to struggle with the go / no go decision. I consulted with the advice of my scholar, astrological chart and prayer book. However, the cases for and against colonoscopy seem to balance out. (Yes, of course, I joke about the astrological chart and the prayer book.)
I admit that, weighing two options, I began and remained biased in favor of the option “give him a pass”. Paraphrasing Chaplin when he was seen in close-up, the prospect of undergoing this humiliation seems tragic. However, I suspect that if I had to go through this and find that the test results allowed me to remain on the surface of the planet even longer, my vibrations would seem to be comedic, in retrospect.
Influential people in my life have been for many years after me to undergo this procedure. This important group includes my primary care physician, my son and my wife. Their well-thought-out problems, of course, are highly valued and appreciated. Nevertheless, I suspect that they are affected by excessive caution regarding hidden future problems in combination with too little concern for the incompetence of the whole process and the high probability that this will be unnecessary. Unfortunately, the pressure to no longer resist - just do it, it was almost unbearable.
The last onslaught began about a month ago during a training trip. A cycling friend and athlete champion about my age, what I call Sandy, asked me if I had a colonoscopy, laTely. I answered no. For the next interrogation, I had to admit that I had no plans anytime soon. I thought this was the end. Not this way. Later this morning I received a long email from him. He argued that as a “guru of well-being,” my audience expects that I will also be interested in my health. He argues that modern colonoscopy (compared to what good doctors did in the Middle Ages?) Is quite simplified and that in my old age I read how things grow (except for the hair on the nose). Thus, he meant that there is a high likelihood that one or more polyps will be found in my colon. He called me a "stubborn old goat." But he softened it, adding that “those of us who admire and love you will be sad if my resistance is fatal, a funeral and stop reading my weekly newsletter for wellness.
It was all very effective and motivational, especially the parts related to flattery. I asked several colleagues, including several medical friends, for their opinions on this issue. About half of the recommended was unnecessary; the others said it was a good idea. The latter, however, did it for reasons that were struck by this: "It will make everyone who is concerned about your best interests feel good if you did it."
I realized that if I had this test, it would be done to please my son, my wife, my doctor, Sandy, and others who are big fans of the colonoscopy. These people all prefer a bit of discomfort now to be safe.
However, a friend of a doctor in Perth noted that some medical groups, including the Preventive Services Task Force, set 75 as the age to stop routine colon cancer screening. His opinion is that those (like me) who consume a diet rich in fiber, and otherwise live reasonably, probably do not need this procedure. He also noted that colonoscopy does not advance in Australia and is not covered by the Australian universal health insurance system. He basically does not recommend. Many others have expressed a similar position, some of which have quite accurately given the history of excessive testing in this country, which can be dangerous and costly for society.
Well, I'm still on the notorious fence. I made an appointment with a doctor recommended in early February. I plan to take my hesitations and problems. Maybe a good doctor will help me see the light. Probably no.
Needless to say, at the moment I do not recommend for or against the colon screen for anyone else. But I recommend that you do what I did, read pros and cons, and collect all your problems and questions — and discuss them with a knowledgeable health care professional. If necessary, get a second or third third opinion. This is a good idea when considering any kind of invasive medical test or procedure. Then do what you think is rational. Do not send for testing or anything else to please relatives or friends. Even if they threaten to boycott your funeral.
Good luck.
