Dumb and Dumber – Noncompliance with Colonoscopy Post Positive FIT

Results Some 88 013 patients who were FIT positive complied with colonoscopy (males: 56.1%; aged 50–59 years: 49.1%) while 23 410 did not (males: 54.6%; aged 50–59 years: 44.9%).

The 10-year cumulative incidence of CRC was 44.7 per 1000 (95% CI, 43.1 to 46.3) among colonoscopy compliers and 54.3 per 1000 (95% CI, 49.9 to 58.7) in non-compliers, while the cumulative mortality for CRC was 6.8 per 1000 (95% CI, 5.9 to 7.6) and 16.0 per 1000 (95% CI, 13.1 to 18.9), respectively. The risk of dying of CRC among non-compliers was 103% higher than among compliers (adjusted HR, 2.03; 95% CI, 1.68 to 2.44).

Conclusion The excess risk of CRC death among those not completing colonoscopy after a positive faecal occult blood test should prompt screening programmes to adopt effective interventions to increase compliance in this high-risk population.

Non-compliance with colonoscopy after a positive faecal immunochemical test doubles the risk of dying from colorectal cancer — https://gut.bmj.com/content/early/2021/03/30/gutjnl-2020-322192?rss=1

Help me understand human behavior. You get a positive FOBT or Cologuard test and your doctor says you need a colonoscopy but you decide not to follow up and follow through with the scope.


9 thoughts on “Dumb and Dumber – Noncompliance with Colonoscopy Post Positive FIT

  1. This is so important for everyone. I had my five year follow-up last November and three large polyps were found. My next follow-up will be in three years. I believe at age 80 they usually stop performing colonoscopies but take it on a case-by-case basis considering life expectancy?

    I think I read that now age 45 this when the first screening colonoscopy is recommended?

    • Life expectancy yes and more importantly family history. My last scope was 4 years ago with 4 adenomas removed. I have a first cousin who died age 49 from CRC so my first scope was in my early 40’s. The recommended age for the first screening keeps getting younger as the incidence of CRC worldwide is increasing at younger ages. Of course this is not diet related. NOT.

  2. Are you being facetious about not diet related?

    I don’t have any colorectal cancer in the family that I know of. But I don’t have many relatives at all. No siblings or cousins. The cancers I know of were prostate and breast in my parents.

      • I definitely thought so about the diet. 😁

        I just read your post on Twitter about implicit racial bias or lack there of, some doctors think. I believe there is widespread racial bias in the medical profession. I’m not sure that this training some of the states require is going to make any difference. But racial bias definitely exists. I know for certain In obstetrics. Maternal mortality is much higher in African-American women when other variables such as class and age and comorbidities are taken into consideration. And I think there are a whole lot of other racial bias things such as access to care, ability to takeoff from work to see the doctor, not being taken seriously when they do see a doctor, living in food deserts with no access to fruits and vegetables, and many many more things as well. I think racial bias is kind of like alcoholism. Denial is the hallmark of the condition.

      • You are in a better position to comment on racial bias in medicine but I would agree as a semi-disinterested outsider. I also agree with your comment on training. I have taken such training and it’s worthless. The “training” does not solve any problems and IMO is simply people/businesses doing something/anything just to say inclusion/diversity/non-bias is one of our “values”. Racial bias definitely exists but the solutions are hard to come by. Like any problem facing humanity this is a work in progress.

  3. Those trainings are merely a check in the block. But at least at this point it is a work in progress. Until quite recently, I don’t think there was much progress whatsoever.

      • I agree. I was on one of my Mensa forums this afternoon, and a whole bunch of people we’re trying to say how former police officer Chavan was justified in what he did and should be found not guilty. They were saying George Floyd died from a drug overdose and Chavan‘s knee was just on the shoulder blade. These people are in the top 1% of the world’s IQ! I think they’re also in the top 1% of racists.

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