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 ...
My doc said if you don't smoke and you are male, colon cancer is the number one killer...and there are no symptoms of colon cancer.
I'm not sure about his claim that it is above heart problems, etc.
"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."
You might want to talk to your doctor. There are alternatives to drinking a gallon of laxative. I've had three of these things, I know.
The first one was three years ago. The doctor found a few polyps. He told me later that he didn't have time to remove them so I'd have to come back for a second a couple of weeks later.
Three years later, I had to have another. I insisted on another doctor. This one offered me three alternatives for the prep. I could drink the gallon. I could take two pills and drink two four oz. laxatives. Or, I could take a bunch of pills. I choose the combination. Much better. Found more polyps so I'll have to redo in three years.
Still, I wonder if the first doctor who didn't have time during the first procedure is the kind who only spends a few minutes. Evidently, there is a chance that the second doctor is much more thorough since he obviously doesn't stack his appointments so tightly.
"Um, I am a gastroenterologist. "
Love your screen name!!!
wow, you can refuse the drugs? Was it painful?
Now you tell me.
The doc who scoped me in August found a polyp but now I'll always wonder if it was just for show--you know, an obigatory snip to "prove" he had been thorough when in fact, he had not been.
On the other hand, he was an older guy in his late 50s or early 60s and he had me on the table for about 20 minutes. I figure if he's been river-running that long he ought to be able to spot the bad boulders more exactly and faster than a less experienced doc. But that's a weak inference, I realize.
My understanding is that it takes awhile for a benign polyp to become cancerous and that by the time they do, it's very obvious. In other words, if I'm going back to be scoped once a year (which is the plan now) the doc ought to be able to spot any bad stuff well before it gets too bad even if he's missing some tiny polyps with each scoping.
In any event, I'm glad I had the procedure done. It was only slightly annoying and not at all painful.
Thanks for the tip...I'll ask..
Perhaps we should warn folks - the laxative they prescribe for these procedures has a warning label: DO NOT LEAVE HOME DIRECTLY AFTER CONSUMING THIS LAXATIVE.
They MEAN it folks....There will be 10 second warnings - MULTIPLE times to get to your porcelain throne... NO MORE time than that.
Semper Fi
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"wow, you can refuse the drugs? Was it painful?"
Refusing the drugs seemed to anger the doctors at the VA and yes it was painful, but I had to drive myself home and didn't want to be sedated, plus I think I have a little problem with giving up too much control.
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