In today's Study of the Week, Vinay and I offer commentary on one of the most important trials of the year--the NordICC trial of screening colonoscopy.
I had an epiphany reading this... neither my husband nor I have ever had colonoscopies (mid-60s), and I have never had a mammogram. So it is entirely consistent we wouldn't take an untested vaccine! The pressure I've had to take a mammogram probably exceeds that to take the covd vax! Anyway, colon cancer is highly correlated with diet per my research. Western medicine is entirely driven by big pharma, and the people accept that because it gets them off the hook to actually get outside, exercise, and eat right. We are responsible for our own health! Thanks for this info this morning... gonna be sharing it with others that are on the fence.
Another example of how medical marketing trumps good medicine. If the scope is not properly rinsed it may introduce pathogens to the next patient and or destroy all the normal microflora!
Old news. Here's what I wrote in Butchered by "Healthcare":
Looking for [colon cancer] using colonoscopy in people without known symptoms has no credible scientific support. Despite this, we spend billions of dollars on it every year. The risks include bleeding, colonic puncture, and an occasional death.
In private, gastroenterologists refer to colonoscopy as “extracting a $1000 bill from the bowel.” Wide variations in regional frequency of colon scoping are evidence of overuse. There are standard recommended intervals for repeating the procedure, but some doctors tell their patients to come back for another look more frequently.
In 2018, the American Cancer Society (ACS) reduced the age recommendation for screening colonoscopies from 50 to 45 years old, bringing in millions of extra patients. Most other countries have better control over their physicians. Standard guidelines abroad are to do a colonoscopy only if there is pain, blood in the stool, or other clinical finding.
“Polyp snaring” is the removal of nipple-like fleshy lumps sticking out of the inside of the bowel using wire loops. Since these can sometimes be precancerous, taking them out could theoretically decrease the chances of invasive cancer developing later. The money made from turning this trick is often half a gastroenterologist’s income. But with it comes temptations. An anonymous GI lab nurse working in a respected Los Angeles hospital told me:
About half the docs here are crooks. With every single colonoscopy, they suck a little piece of normal bowel wall into the scope, snip off the healthy tissue, and send it to the lab. They call it a polyp and bill thousands. Since the pathologists get paid just to look at the specimen, they always say the tissue is “non-specific dysplasia” instead of normal. This qualifies as a polyp, at least for billing. These GIs are one-trick ponies when it comes to making money. Colon scoping and polypectomy is all they have besides the occasional ERCP (endoscopic retrograde cholangio-pancreatography), which is a lot harder and more dangerous for the patient.
We now have Cologuard, a $600 Medicare-reimbursed stool test for colon cancer. This pricing is typical—it is as high as the company can get away with. Compared with colonoscopy, which costs over $2000 and has risks, this almost seems reasonable. Cologuard supposedly detects 92 percent of colon cancers and 42 percent of advanced polyps with every use. The gastroenterologist does a colonoscopy if the test is positive. If they find anything, surgery or endoscopic removal is done.
Incredible information. It's even worse than I thought. We actually know of 2 people injured and had to be hospitalized for injury during this procedure! Thanks for the info!
I had an epiphany reading this... neither my husband nor I have ever had colonoscopies (mid-60s), and I have never had a mammogram. So it is entirely consistent we wouldn't take an untested vaccine! The pressure I've had to take a mammogram probably exceeds that to take the covd vax! Anyway, colon cancer is highly correlated with diet per my research. Western medicine is entirely driven by big pharma, and the people accept that because it gets them off the hook to actually get outside, exercise, and eat right. We are responsible for our own health! Thanks for this info this morning... gonna be sharing it with others that are on the fence.
Another example of how medical marketing trumps good medicine. If the scope is not properly rinsed it may introduce pathogens to the next patient and or destroy all the normal microflora!
Old news. Here's what I wrote in Butchered by "Healthcare":
Looking for [colon cancer] using colonoscopy in people without known symptoms has no credible scientific support. Despite this, we spend billions of dollars on it every year. The risks include bleeding, colonic puncture, and an occasional death.
In private, gastroenterologists refer to colonoscopy as “extracting a $1000 bill from the bowel.” Wide variations in regional frequency of colon scoping are evidence of overuse. There are standard recommended intervals for repeating the procedure, but some doctors tell their patients to come back for another look more frequently.
In 2018, the American Cancer Society (ACS) reduced the age recommendation for screening colonoscopies from 50 to 45 years old, bringing in millions of extra patients. Most other countries have better control over their physicians. Standard guidelines abroad are to do a colonoscopy only if there is pain, blood in the stool, or other clinical finding.
“Polyp snaring” is the removal of nipple-like fleshy lumps sticking out of the inside of the bowel using wire loops. Since these can sometimes be precancerous, taking them out could theoretically decrease the chances of invasive cancer developing later. The money made from turning this trick is often half a gastroenterologist’s income. But with it comes temptations. An anonymous GI lab nurse working in a respected Los Angeles hospital told me:
About half the docs here are crooks. With every single colonoscopy, they suck a little piece of normal bowel wall into the scope, snip off the healthy tissue, and send it to the lab. They call it a polyp and bill thousands. Since the pathologists get paid just to look at the specimen, they always say the tissue is “non-specific dysplasia” instead of normal. This qualifies as a polyp, at least for billing. These GIs are one-trick ponies when it comes to making money. Colon scoping and polypectomy is all they have besides the occasional ERCP (endoscopic retrograde cholangio-pancreatography), which is a lot harder and more dangerous for the patient.
We now have Cologuard, a $600 Medicare-reimbursed stool test for colon cancer. This pricing is typical—it is as high as the company can get away with. Compared with colonoscopy, which costs over $2000 and has risks, this almost seems reasonable. Cologuard supposedly detects 92 percent of colon cancers and 42 percent of advanced polyps with every use. The gastroenterologist does a colonoscopy if the test is positive. If they find anything, surgery or endoscopic removal is done.
Readers of this substack can have a free ebook copy if they can't afford $4. See: https://dl.bookfunnel.com/4kliod8a9z
Incredible information. It's even worse than I thought. We actually know of 2 people injured and had to be hospitalized for injury during this procedure! Thanks for the info!
Dr. Micozzi has been saying this for years.
https://drmicozzi.com/tag/colonoscopy
I finally did the Cologuard one last year. Came back fine and it is a inhome test you send off.