No More Colonoscopies!

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Among those who are screened [for colorectal cancer], colonoscopy is by far the most popular method in the U.S. But there is a menu of options beyond colonoscopies — and they’re not necessarily any better or worse….Included on the list are two cheap, at-home poop tests intended to be done annually: the guaiac-based fecal occult blood test (gFOBT) and a more sensitive test called the fecal immunochemical test, or FIT. Both look for tiny amounts of blood in the stool that might be shed by cancer or polyps. You get one from your doctor, take a poop sample at home, and then return the sample to the doctor. Only if you get a positive result do you need to have a colonoscopy.

….No one is arguing colonoscopy is a bad test. It just hasn’t been shown to be better than an annual FIT, said James Allison, a clinical professor of medicine emeritus at the University of California-San Francisco. He said the public health message is slowly changing to reflect that.

Well, this answers a question for me. I’ve never had a colonoscopy, and I’ve always wondered why my doctor has never insisted on one. Now I know. Just yesterday, I did my annual poop test. I’ve been doing them for years without really knowing why. Kaiser sends me a little kit every year, I do my business, and send it back. I guess Kaiser has decided to use FIT as their default colorectal cancer screening method, and that’s why no one has ever asked me to schedule a colonoscopy.

Given my personal experience, I should mention that the poop test is, excuse the pun, a little more of a pain in the butt than this article suggests. I’ll spare you the details, but it turns out to be a little tricky from a pure manual dexterity standpoint. And of course it’s a wee bit disgusting. Still, if you’ve ever cleaned out a cat box or picked up after a dog, it’s not any big deal.

UPDATE: As long as we’re on the subject of routine health procedures, there’s also this:

The federal government has recommended flossing since 1979….The guidelines must be based on scientific evidence, under the law. Last year, the Associated Press asked the departments of Health and Human Services and Agriculture for their evidence, and followed up with written requests under the Freedom of Information Act….The AP looked at the most rigorous research conducted over the past decade, focusing on 25 studies that generally compared the use of a toothbrush with the combination of toothbrushes and floss. The findings? The evidence for flossing is “weak, very unreliable,” of “very low” quality, and carries “a moderate to large potential for bias.”

Apparently the government agrees: In its latest dietary guidelines, the recommendation to floss every day was quietly removed.

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