Colon Cancer Screening Should Start Earlier, at Age 45, U.S. Panel Says | Hacker News Reader

Colon Cancer Screening Should Start Earlier, at Age 45, U.S. Panel Says

nytimes.com

31 pointsfortran7713 comments

Had a bit of a scare a few years ago at age 29. Due to a family history of digestive issues, the doctor figured a colonoscopy would be worth doing. There was a long thread about this a few days. It's not big deal. You drink a gallon of salt water, visit the bathroom a few times, and the procedure can take place in a small sterile doctor's room - a mini hospital, you can say. Within 30 minutes of waking up from the anesthesia I was back in the office. Hardly a big deal. The hardest part wasn't the prep, it was being hungry and running out of shows to watch on Netflix. Just do it if you're in the age bracket and haven't already.

“Colonoscopies are very often done with anesthesia in the U.S., making them essentially minor surgical procedures. A 2016 analysis found that for every 1,000 colonoscopies, about 16 people will end up hospitalized within a week.”

https://fivethirtyeight.com/features/how-early-is-too-early-...

How many of the 16 got colonoscopies because of symptoms vs routine checks?

Norwegian doctors Michael Bretthauer and Mette Kalager have come out with a detailed argument against early testing for colorectal cancer and instead recommend tests begin by invitation at age 55. Earlier onset of colorectal cancer is rare and strongly associated with other risk factors such as family history and bowel problems such as IBS. In most cases the polyps that can lead to cancer do not even begin to form until the age of 55. Early testing is a significant amount of money traded for little expected result. There is such a thing as too much testing and we need to be targeted in our use of medical resources.

http://sciencenordic.com/should-colon-cancer-screening-start...

Important correction:

> Having IBS doesn’t increase your risk of colon cancer

https://www.healthline.com/health/ibs-vs-colon-cancer

Probably a good idea for most people but there are risks. About 1 in 3000 colonoscopies result in a colon perforation.

https://peterattiamd.com/colorectal-cancer-screening/

I can't think of any medical procedure or drug that's 100% without risks. And, as far as risks go, 1 in 3000 is pretty good. There are drugs out there that have around a 1 in 1000 chance of causing Stevens-Johnson Syndrome, wherein the sufferer's skin starts falling off. [0]

There are definitely situations in which I would accept a 1 in 1000 risk of my skin falling off. On average, that should be no worse than 3 colonoscopies, then, right? Given the benefits as a screening test, I'll take that risk.

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[0]: https://www.mayoclinic.org/diseases-conditions/stevens-johns...

There's a nice visualization of colon cancer by age here: https://fivethirtyeight.com/features/how-early-is-too-early-...

The population as a whole is getting it and dying of it less often. At the same time, cases among 30 and 40-somethings are rising rapidly.

I had mine at age 43 and was lucky to have had noticeable bleeding early on. Very often obvious symptoms show when it is too late.

Diagnoses among 30 and 40 somethings are rising in large part because the amount of testing has been greatly increased and well as the sensitivity of the tests. Accounting for changes in testing flattens out recent increases in positive diagnoses.

I've heard a few explanations, including that one, but haven't yet seen solid support for it.

My oncologist suggested it may be related to changes in diet as a result of the shift toward processed foods. I definitely was a part of that experiment, with lots of canned food and frozen meals when I was young.

I lost a wife at 37 due to it. No prior symptoms that I am aware of. The cost to the system of a cancer treatment (average life span is 3 years with stage 4) must be enormous not to mention the dear lives ended too early.

Related discussion about a 34 year old's diagnosis: https://news.ycombinator.com/item?id=24853503

I lost a childhood friend who discovered hers by accident. She was 37 and somewhat healthy, she left two daughters (4 and 7)

If you can, do a screening earlier.

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