
Start colon cancer screening at 45, not 50, American Cancer Society urges - mudil
https://www.usatoday.com/story/news/2018/05/30/american-cancer-society-colon-cancer-screening-45/651959002/
======
simulate
Annual home stool tests (FIT) mentioned in this article can be as effective as
colonoscopies. My provider, Kaiser-Permanente mails a kit once a year and I
mail it back so no appointment is necessary and it's a lot less invasive.

538 wrote a good piece about the advantages of FIT vs. colonoscopy: "You Could
Skip Your Colonoscopy If You’re Willing To Collect Your Poop"
[https://fivethirtyeight.com/features/you-could-skip-your-
col...](https://fivethirtyeight.com/features/you-could-skip-your-colonoscopy-
if-youre-willing-to-collect-your-poop/)

~~~
dghughes
I agree FIT kits are great especially to ease your mind if you're worried
about colon cancer.

But the FIT kit can be difficult to use with two main problems. It's like
bobbing for apples only much less fun. You can't urinate or it ruins the
sample. I don't know about you guys but I find it almost impossible to avoid
urinating when defecating.

And with that happy mental image have a nice day everyone! And remember to eat
lots of fibre.

~~~
lambda
> I find it almost impossible to avoid urinating when defecating

Can't you just urinate first, flush, and then defecate?

~~~
ASalazarMX
Fishing out poop from the toilet? No. Buy latex gloves and poop in your hand
like every self-respecting primate.

~~~
modbait
...then fling it right into that envelope!

------
Nihilartikel
Datapoint: At 36 I noticed small amounts of blood in my stool intermittently
over the course of a year and told my GP. He said it was probably nothing
(hemorrhoids) but that I could get a sigmoidoscopy if I was really concerned.
I did, and right around-the-corner was a big old polyp. The Gastroenterologist
was surprised. Had 3 more removed in the following colonoscopy. None
cancerous, thankfully, but who knows how much longer that would have lasted. I
should also note that bleeding is not a very common symptom. Usually there are
none, so I got lucky.

He said that my bowels were pretty bad looking, like a 70 year old. This
surprised me since I thought I had a pretty good diet for most of my adult
life, and very good in my 30s. I had a garbage diet as a child and teenager
though.

I really can't guess what's driving the trend of bowel disease in younger and
younger patients, but I am following news on it with great interest.

~~~
orev
You can’t guess?

> I had a garbage diet as a child and teenager though.

------
ytNumbers
Always check the online reviews before going to any doctor. A bad doctor with
zero ethics might be tempted to do a "rush" job on you. If you want to know
what that experience would be like, click the link below:

[https://www.youtube.com/watch?v=SmW9Pl7R1dc&t=238s](https://www.youtube.com/watch?v=SmW9Pl7R1dc&t=238s)

~~~
nradov
Online reviews by patients are almost always useless and have near zero
correlation with actual evidence-based medicine care quality. Studies have
shown that patient satisfaction is most impacted by whether the doctor writes
a _prescription_ , regardless of whether the patient really needs one.
Apparently patients like to feel they're getting something for their money.

~~~
heymijo
Would you mind citing your sources?

~~~
nradov
Here you go:
[https://www.bmj.com/content/315/7117/1211.short](https://www.bmj.com/content/315/7117/1211.short)

------
JacobJans
Bowel disease is becoming a widespread problem in the United States, and is a
big factor behind the increasing popularity of specialized diets such as The
Whole 30 Diet, Keto, Paleo, gluten free, etc.

Many people's bowels are not happy, and they're looking for answers by
modifying their diets.

The increase is colon cancer among younger people is likely a result of the
increased bowel disease among younger people.

The medical establishment is not really equipped for handle this rise in
disease; much of the focus is on the development of expensive drugs that are
basically cash-cows for pharmaceutical companies. For example, Remicade costs
up to $20,000 a month -- and the market of potential users of it is many
millions of people.

The financial math for researching non-drug treatments simply pales in
comparison to the potential payoff for successfully developing a drug, even if
the results are far-inferior to alternative approaches.

~~~
vonmoltke
> For example, Remicade costs up to $20,000 a month -- and the market of
> potential users of it is many millions of people.

That is the _annual_ cost:
[https://en.m.wikipedia.org/wiki/Infliximab](https://en.m.wikipedia.org/wiki/Infliximab)

~~~
JacobJans
Those numbers are from 2007.

The prices have increased dramatically. (Because, why not? They can get away
with it.) Of course, it varies, depending on "a number of factors"

> Drug cost was $19,727.34. Total for 1 infusion is $22,278.02.

[https://www.howmuchisit.org/remicade-infusion-
cost/](https://www.howmuchisit.org/remicade-infusion-cost/)

~~~
LinuxBender
I have a friend that requires this shot. He has to stay unemployed so that the
government will pay for it.

~~~
namibj
Well, teach/guide him to do open source development? That way he can even do
good, and, possibly there might be a charity of some sort that loans the
necessary equipment for him to do the work, and as long as he doesn't own
it/can't use it for his own good (might be considered as taxable income then),
he could probably get away with it. Don't feel bad. UBI is there, just with a
shitload of bureaucracy around it.

~~~
LinuxBender
He rebuilds cars. He has no interest in learning how to code. That said, he
does really good work rebuilding and restoring old cars for people. I have
seen him contribute to society in other ways, including standing up for a
small business owner that was being bullied by a local thug that is the son of
a Sheriff.

------
francisofascii
Link to the research paper:
[https://onlinelibrary.wiley.com/doi/full/10.3322/caac.21457](https://onlinelibrary.wiley.com/doi/full/10.3322/caac.21457)
and press release:
[http://pressroom.cancer.org/releases?item=770](http://pressroom.cancer.org/releases?item=770)

------
devdrew
With enough money, I'm sure a whitepaper can be written to support getting
Cancer screenings at 20. If you make most of your money off removing polyps
then the way to increase revenue is to get more people screenings.

~~~
lloyd-christmas
Not everything is a conspiracy.

 _Colon and rectal cancers have increased 51% among adults under age 50 since
1994, the cancer society said._

That isn't a white paper.

> If you make most of your money off removing polyps

Preventative medicine is cheap. In accordance with the ACA, polyp removal is
guaranteed to be covered if discovered during a colonoscopy. Don't want it
removed? Maybe it becomes cancerous. Now you've moved on to curative care.
Cancer medications can cost over $100k. Surgery to remove the colon is $35k+.
These are just small pieces of a larger puzzle including other treatments,
readmission risks for related illnesses, etc. Now you're done all your
treatment and you've moved on to palliative care. If treatment succeeded, you
have costs associated with the constant infections related to a colostomy bag.
If the treatment fails, now you have the costs associated with end-of-life
care.

If you want your conspiracy to hold some weight, they would be pushing the age
in the _other_ direction.

~~~
gitgacutils
> Colon and rectal cancers have increased 51% among adults under age 50 since
> 1994, the cancer society said.

Percentages can be deceiving. 51% off what base? Was it 100 people in 1994 and
now it is 151?

> Preventative medicine is cheap.

Sure, if the odds of you getting it is high enough. If the odds of getting it
is low, does it make sense for tens of millions of adults to get invasive and
potentially dangerous check ups?

Not everything is a conspiracy, but we do know that "institutions" love to
fear monger to get more money, funding and exposure.

> If you want your conspiracy to hold some weight, they would be pushing the
> age in the other direction.

Not necessarily. Collecting $200 from 10 million people each for an annual
checkup vs the cost of a few thousands with colon cancer. There is a reason
why businesses ( like nflx and amzn ) love the subscription model.

~~~
lloyd-christmas
> Percentages can be deceiving. 51% off what base? Was it 100 people in 1994
> and now it is 151?

Maybe I'm just too close to the source (my father is an oncologist), but I
thought it was well known that colon cancer is one of the most prevalent. It
ranks 4th behind breast, lung, and prostate, of which only lung is deadlier.
There are 140k cases per year and 50k deaths.

> we do know that "institutions" love to fear monger

I don't know what institutions you're referring to, but I don't think cancer
needs any boost from fear mongering, it's already a serious-enough disease.

~~~
Omnus
Sure it's well known. But that's not what he was asking. He was specifically
asking about the number of cancers in people below 40. 140k is for all ages.

------
bedhead
One of my best friends just got diagnosed with colon cancer at 38. Surgery
last week, hasn’t even gotten the pathology report yet. Anecdotal I admit but
when it hits close to home you see things a little differently.

------
Ensorceled
Also, can we pass a law that if the person doing a screening colonoscopy finds
"1 polyp" that turns the diagnostic into a far more profitable "treatment"
they lose their medical license? And can we make that law retroactive?

~~~
ch4s3
> can we make that law retroactive

No, we can't make laws retroactive, at least not in the US, and why would you
want that anyway?

*edit for formatting

~~~
wafflebear
Only criminal laws are prohibited from being retroactive, because the Supreme
Court works in mysterious ways.

~~~
ch4s3
I assumed the parent meant a criminal penalty. But, I still don't understand
why anyone would want the government to have such a capricious legislative
power.

------
squozzer
The article doesn't mention the percentage of colonscopies among 50-year-olds
that find something bad. If say it was 30%, that sounds like a great reason to
start sooner. 5 - 10% maybe not so much.

------
sharadov
"Eat food. Not too much. Mostly plants."

------
rajadigopula
Or start including fermented foods like Sauerkraut at least a day in the meals
and keep away from junk food. Prevention is always better than cure.

------
ams6110
tl; dr: experts disagree.

------
jbob2000
"Stop eating so much red meat" \- What the American Cancer Society _should_ be
urging.

[https://www.health.harvard.edu/newsletter_article/red-
meat-a...](https://www.health.harvard.edu/newsletter_article/red-meat-and-
colon-cancer)

~~~
itamarst
According to that article this will decrease your risk by... 25%. Which is
nice, but not massive on an individual level.

~~~
sgc
As someone who loves red meat, I find 25% extremely significant on a personal
level.

~~~
ams6110
The lifetime risk of developing colon or rectal cancer is about 4.5%. Assuming
research cited above is correct (a big assumption, considering the history of
medical research) and red meat consumption increases that 25%, your risk is
now about 5.5%.

Edit: I misread; the claim is in the other direction, that cutting red meat
reduces your risk. So 4.5% becomes 3.4%

