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.
In either case unless there are specific genetic concerns or symptoms warranting tests, the risk of test complications and reacting to false positive results nearly match the benefits. Age is also a significant factor in benefit analysis of aggressive treatment particularly with respect to prostate cancer.
I have reached the magic age of 65 and all the "preventative and detection" tests the doctors wanted in my 50's are suddenly off the table to them.
When I asked mine why the change he said that the medical community has re-evaluated the value of general population testing due to false positives on PSAs and that after a certain age, something else was likely to get me first.
Likewise he said that colon cancer is very slow developing and the risk of puncturing the colon, infection, adverse reaction to anesthesia and other complications are as great a risk as having the test. He does do a bi-annual occult blood test.
BTW if you take antistatins, there is a new take on that too. Many people taking them don't need to and the medical community just changed the threshold criteria on that too.
Just think, five years ago this was all "settled science"
what is an antistatin?
My husband was asymptomatic at 50 and had stage 3 prostate cancer. The cancer just made it outside the prostate cancer and into the nerve bundle. It was aggressive! He would have died if he had waited much longer.
He’s been cancer free for over 4 years.
So you are saying you are full of $hit. Straighten up and post right man!
Cholesterol lowering drugs like Lipitor.
Had one last month under anesthesia for under 2k before insurance. BCBS payed $500.
Another one of those it makes no difference studies designed by bean counters and not doctors. The goal is to cut health care costs by in effect rationing care. Sure the number of cancers not detected by fecal blood tests is “small”, but anyone in this small percentage likely has advanced cancer before it is detected and dies as a result. Same BS about less frequent mammograms and PSA tests. Because of a family history I have colonoscopies every five years and a small pre-cancerous polyp was detected and removed during my last procedure. I had fecal blood tests every year with my annual exam they detected nothing.
USAA is a great company and I use them too but they do not sell health insurance.
“I do not have to go to Texas to live, to drive or to get sick. They write my policies to state specifications, not federal and my preferences.”
I see your point. Still, selling auto insurance across state lines does not reduce the cost of the insurance because the insurance has to match the requirements of the state where you live. You can’t go to USAA and ask for your insurance rates to be based upon living in Wyoming when you live in Texas.
This whole idea that since health insurance costs are cheaper in one state than in another offers an opportunity to save money is simply wrong. The only way you can sell across state lines and save money is to do away with state requirements. You don’t think the state or the feds will just allow you to buy the specific coverage you think is necessary do you? Why you might not buy the coverage the government wants you to buy.
Actually, it is your fellow citizens that drive those requirements. The women’s groups insist the state mandate insurance for abortions. The Mother Against Drunk Drivers want coverage for alcohol abuse. Politics drives what is covered.
The more I read about the statin busters the more I think they will be the next big class action lawsuit like asbestos and tobacco. Big money for pharmaceuticals and totally unnecessary for virtually everyone. My Dr had fits when I quit taking them a few years ago and went on low/no carb/sugar high fat diet. not that I’m worried about it, but cholesterol is lower now. Dr still doesn’t like it, but doesn’t bug me about resuming Lipitor.
When I had mine done, I did not go under. I watched the whole thing! It was interesting. Well, the drugs may have made it seem that way. They were really surprised I did not go out but it makes me wonder why. lol
If they don’t have health insurance it’s just recently that they stopped. They had it 3-4 years ago when I checked for my son.
$33,000?
My husband just had a colonoscopy in Singapore. Total cost was $3,550.00 Singapore dollars.
The difference in cost is amazing. Since plane tickets round trip are around $3000, medical tourism is worth investigating.
33,000?
That’s half what my open heart cost in 2005
Crazy
You can get a contrast CAT of the colon for about 1200 max
Ever since then I am told to have a colonoscopy every 5 years, but my siblings are only required to have one every 10 years. (Different doctors.)
No, DO, I don’t think they were inappropriate.
Living in the Coachella Valley, the low desert of Southern California (think Palm Springs area), we see many Canadian “snow birds” here every winter. They flock here in droves along with lots of Canada geese.
Guess what? They flock to our local hospitals, mainly Eisenhower Medical Center. Why are they going there? Well, it is because there is little to no wait for the numerous non-emergency surgeries which they need. Surgeries on which the waiting time under Canada’s socialized medicine can be many months, can be scheduled here in a matter of days or a couple of weeks.
We have so many Canadians at Eisenhower, that the hospital has set up special payment plans designed specifically for Canadians.
Your insurance way overpaid
I just looked it up
Average cost is 1500 but can go up as high as 15,000 if complications like multiple polyps or abnormal fold excisions
One company in Dallas and elsewhere called Colonoscopy Assist will do them including sedation and procedure etc for 1075.00
“Procedure cost $33,000, including anesthesia.”
Neither US or state governments (Medicare, Medicaid, etc.) or private insurance plans are paying that figure. Take a look at any hospital bill after processing by the insurer, and you will see that hospitals typically receive 10 cents or less on each dollar billed. Doctors also get a huge reduction in payments. It is a crazy billing system in need of overhaul so that the amount originally billed bears some resemblance to reality.
Didn’t the Trumpster say he liked Canadian health care at one time?
*ducking*
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