Thursday, December 18, 2008

Colonoscopy: As trustworthy as the markets?

A few months ago we learned that many cancers arise from flat lesions that can't be easily seen by colonoscopy. Two years ago we learned that gastroenterologists vary greatly in how many polyps they find, and that accuracy is inversely related to speed.

Now we find that even good gastroenterologists can't find right sided cancers ...
Colonoscopies Miss Many Cancers, Study Finds -

.... In the new study, the test missed just about every cancer in the right side of the colon, where cancers are harder to detect but about 40 percent arise. And it also missed roughly a third of cancers in the left side of the colon.

Instead of preventing 90 percent of cancers, as some doctors have told patients, colonoscopies might actually prevent more like 60 percent to 70 percent ...
Of course it's possible right sided cancers are different from left sided cancers; maybe they don't have the same slow growth from polyps.

I also suspect that, like most routine procedures, gastroenterologists do best in the first 1-3 years of scoping, then do worse as the procedure becomes easy and routine.

In any event, it's been a bad few years for colonoscopy. The procedure now looks like a bit of a fraud.

We don't have know of anything better, but clearly we ought to review our options. Since it's not as good a test as we thought it was maybe we should start paying less for the procedure.

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