Posted on 02/23/2016 2:14:57 PM PST by originalbuckeye
TORONTO-New Canadian guidelines say colonoscopy should not be used for routine screening to detect colorectal cancer in patients with no symptoms or family history of the disease.
The guidelines from the Canadian Task Force on Preventive Health Care strongly recommend that low-risk patients aged 50 to 74 be screened using fecal occult blood tests every two years or sigmoidoscopy every 10 years.
Sigmoidoscopy involves the insertion of a flexible scope to view the lower portion of the colon and rectum rather than the entire tract, as is the case with colonoscopy.
The task force also advises against screening asymptomatic patients age 75-plus because of their reduced life expectancy and the lack of research showing benefit or potential harms of the tests.
Task force member Dr. Scott Klarenbach of the University of Alberta says the guidelines do not apply to high-risk patients who have symptoms or a family history of the disease.
Colorectal cancer is the second most common cause of death from cancer in men and the third leading cause of cancer deaths in women. In 2015, an estimated 25,000 Canadians were diagnosed with colorectal cancer, and approximately 9,300 died from the disease.
"Although colonoscopy may offer clinical benefits that are similar to or greater than those associated with flexible sigmoidoscopy, direct evidence of its efficacy from randomized controlled trials in comparison to the other screening tests . . . is presently lacking," said Dr. Maria Bacchus, an internist at the University of Calgary who chaired the guideline working group.
"However, ongoing clinical trials are working to address this research gap," she said.
The new guidelines are based on the latest available research and update the task force's previous 2001 advice, which recommended fecal occult blood testing every one to two years or sigmoidoscopy every five years in asymptomatic adults.
The Canadian guideline is similar to the 2008 U.S. Preventive Services Task Force recommendation that adults aged 50 to 75 should be screened for colorectal cancer using a fecal occult blood test or flexible sigmoidoscopy.
While the U.S. group also recommended colonoscopy, its Canadian counterpart does not believe there is sufficient evidence to support that decision.
The Canadian task force was established to develop clinical practice guidelines for primary-care providers related to a variety of preventive-health issues, based on a systematic analysis of the most recent scientific evidence.
I had my first colonoscopy in 1990 at age 42.
Just a few centimeters from the maximum range of the scope, the Doc removed a golf ball size Tubovillous Adenoma that was (to use his colorful phrase) “ripe and getting ready to blossom into cancer.”
I have no genetic predisposition nor any family history that would have indicated caution. In fact the reason I got the full scope was because the Doc (a personal friend) had me as the inaugural patient in his new endoscopy surigicenter. He wanted to show off his new toys.
Long story short - I had six month follow ups for two years and have been on five year re-checks ever since. Praise God, no recurrence.
But had I been subject to current guidelines, I would have had at a minimum an arduous battle with cancer and in all likelihood I would have died.
But that’s the whole point of Government run healthcare, isn’t it?
No.
They could do a fecal blood test. Cheaper and painless.
Inserting a camera up your ass rarely reveals anything malignant.
I thought the object of that procedure was to remove polyps along with visual inspection. Polyps can become cancerous. But I am not a doctor.
Washington Examiner 11/14/2013
Even if they gave you a tank of nitrous oxide to take home, 33k seems excessive.
Yep,the entire thing is a roll of the dice in many cases.
Sorry you lost your grandmother so young.
.
In a perfect world, there should 535 colonoscopies in congress to check for brain activity.
Yes, that’s a rediculous cost! I guess someone has found a way to nick the government, because I’ve had one (and like the poster, I’m good to go for ten years), it was done in an outpatient clinic, and I was in and out inslide of an hour.
And for a little levity (for those who have had a colonoscopy), you might want to take a gander at this (It’s a little raw, but funny):
It brings home “fond memories” to me!
Not good idea to do it on elderly patients unless they have a history of colorectal cancer.
The time its mostly likely to strike is between the 50-70 year old range.
Sounds like the Canadian health system is trying to save a Loonie or two while hoping the huddle masses don't notice.
Good....Maybe my triennial impaling will cease.
I’ve got a friend whose life has been saved a couple of times with the camera. His guts are a mess.
This is the free prize inside every box of rationed (socialized) medical care.
Seriesly? I would expect in the range of 3-5k$ tops.
I only paid the co-payment, Medicaid covered the bill.
Colon prep....ugh!!!
I am sorry she died so young too, her sister lived to be almost 116 and was the oldest person in the US when she died in about 1996.
— Anything to avoid the day of deliberately induced explosive diarrhea.—
Oh! That’s the most fun part! /s
I didn’t wee it as a race.
My candidate advocates for this.
For sure, and they're trying to do the same thing with PSA tests. They pick the two things that are most likely to kill us men and try to proscribe proper treatment. Medicare only allows one PSA test per year, but your doctor can get others so long as it's a “diagnostic” and not a “screening” code. You can't tell me the effort isn't conscious.
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