Colonoscopic Withdrawal Times and Adenoma Detection during Screening Colonoscopy
Posted on 12/15/2006 10:45:26 PM PST by neverdem
For years, patients and many doctors assumed that a colonoscopy was a colonoscopy. Patients who had one seldom questioned how well it was done. The expectation was that the doctor conducting the exam would find and cut out any polyps, which are the source of most colon cancer.
But a new study, published today in The New England Journal of Medicine, provides a graphic illustration of how wrong that assumption can be, gastroenterologists say. The study, of 12 highly experienced board-certified gastroenterologists in private practice, found some were 10 times better than others at finding adenomas, the polyps that can turn into cancer.
One factor distinguishing the physicians who found many adenomas from those who found few was the amount of time spent examining the colon, according to the study, in which the gastroenterologists kept track of the time for each exam and how many polyps they found.
They discovered that those who slowed down and took their time found more polyps.
“We were all experienced colonoscopists,” said Dr. Robert L. Barclay, a member of the group that participated in the study, Rockford Gastroenterology Associates in Rockford, Ill. “We had each done 3,000 or more colonoscopies before the study.”
Yet, Dr. Barclay added, “if our group is representative of an average group, you will see people who take 2 or 3 minutes and people who take 20 minutes” to examine a colon. Insurers pay doctors the same no matter how much time they spend. Gastroenterologists say colonoscopies can help prevent colon cancer, but warn that there is a pressing need for better quality control.
Still, the experts say, the onus remains on patients to ask for data on how proficient their doctors are.
“Patients assume that one colonoscopist is as good as another,” said Dr. Douglas K. Rex, a gastroenterologist...
(Excerpt) Read more at nytimes.com ...
"Yet, Dr. Barclay added, “if our group is representative of an average group, you will see people who take 2 or 3 minutes and people who take 20 minutes” to examine a colon."
I refused the drugs, and I'm pretty sure they were in there for hours,at least it seemed that way.
This slays me. "First, we kill all the gastroenterologists."
This slays me. "First, we kill all the gastroenterologists."
I know this will sound sick -- but I found my recent colonoscopy an interesting and reassuring experience..
Last year, I was scheduled for a mini colonoscopy, which is where a quick look is taken at a limited length of the colon without any anesthesia. A number of polyps were found and removed for examination.. None were malignant, but it raised my Doctor's suspicion.
So he order a full colonoscopy, which required anesthesia and about 10/15 minutes of "probe" time. Another few polyps were found and removed for examination.. Good news, nothing to be concerned about..
NOW - the interesting thing about both procedures is that the patient is provided a video monitor to watch and see exactly what is going on. The capability of the "probe" was amazing -- Clear video, well lighted - pumps air to "inflate" the colon to see into all the crevices, the ability to excise a polyp and cauterize the wound. The Doctor kept up a running dialog of what we were seeing and why is was so.
Folks should NOT avoid having the procedures - especially those over 55 or 60.. I've already lost a couple of seemingly healthy friends to colon cancer that was not caught in time to prevent death.
Believe me -- the WORSE part of the test is drinking that damned gallon of laxative to flush the system the evening before the test... The test was a piece of cake, and reassuring to get good news.
Semper Fi
Well, this is built on the unspoken assumption that one derriere is as good [or as big] as another. But it is a matter of common knowledge that some are really big derrieres while the others are much smaller. Now, the same logic ought to apply to colons.
Oh, by the way -- I should have mentioned...
Here in the San Francisco Bay area - Males need to keep a sharp eye on the Doctor and staff whenever we have our ass or family jewels exposed..
Most especially if you're expecting something to be "inserted".
</humor> but not much.
Semper Fi
Gives meaning to your tag line for sure.
Can we file this under "No sh**, Sherlock"?
L
Excellent.... and yes -- I guess it would work both ways.
Semper Fi
Trust me -- after that gallon of laxative -- the tubes are pristine!
Pretty and Pink, just like Hillary in her pink pant suit.
Semper Fi
Were you watching it during the proceedure or on a video replay later? If you could take this live, I have gained even more respect for your "Semper Fi". Wow.
Anyone ever hear of a twisted colon as a result of having
a colonoscopy?
Personally I'm still dealing with the shock of the annual prostate exam. The first time I told my doctor I usually made somebody buy me dinner and a couple of drinks first.
And if one more punk kid doctor says "Well at your age..." to me things are going to get ugly.
L
"I am 19, and have never had one of these exams before. Oy..."
You had better hope that by the year 2037 they don't have to shove cameras up your ass as they do now, but then again, by then it may be the law.
Remember, vote Republican.
Eighteen posts on this thread and no Katie Couric jokes yet?
Isn't she covered in #6, albeit indirectly? Besides, the late Khrushchev was affectionately known as "a-hole with ears". You could probably apply that one to her as well.
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