IS COLONOSCOPY OVERUSED?

I’m pretty sure there are no readers out there that actually enjoy the process of a colonoscopy.  (actually–it’s the day BEFORE the procedure that’s the rough part)  We have them done because we are fearful of the ramifications of not finding a cancer early enough.  We follow our physicians’ recommendations as to how often they should be repeated if we have a clear report.  Our doctors are, of course, following the recommendations determined from the medical literature, right?

Not even close.  The recommendations for those with a clean colonoscopy is to wait 10 years before the next one.  In this particular study of Medicare patients, repeat colonoscopies were done too soon in almost 43% of patients.  This is a tremendous waste of resources.

Now, I understand that early detection saves lives.  But we also need to understand that false positives, which occur with a degree of regularity with any cancer screening, come with their own set of problems.  Dangers with the procedure itself (anesthesia, biopsy, etc..) or the stress of a potentially dire diagnosis create additional testing and costs.  With any type of screening, there is balance that needs to be obtained.  We cannot afford to test every single person every single year and identify potential problems that may never develop into real problems.  The health care system here in the US is already massively expensive without this added burden.

The answer?  Prevention coupled with appropriate screening.  Colon cancer has a very long list of things that we KNOW contribute to it.  Prediabetes, animal based diets, constipation, low fiber (both soluble and insoluble), imbalanced bacteria in the gut, heterocyclic amines from grilled foods and probably 20 other things I’m forgetting right now.  The more we do on prevention, the less important the screenings become.  The poorer our lifestyles, the more important the screenings become.  Personally, I would rather prevent something from happening rather than catching it earl

http://archinte.ama-assn.org/cgi/content/abstract/archinternmed.2011.212?etoc

For more than a decade, Dr. Bogash has stayed current with the medical literature as it relates to physiology, disease prevention and disease management. He uses his knowledge to educate patients, the community and cyberspace on the best way to avoid and / or manage chronic diseases using lifestyle and targeted supplementation.







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