Colonoscopy – Just Do It (an almost forgotten post)

I came across this post in my collection of unpublished drafts. I thought I posted this but obviously I didn’t. This article link was intended to be posted before Colorectal Cancer Rates Rising in Ages 50-54. Better late than never, I guess.

More than one quarter of colonoscopies carried out in Americans aged 30 to 49 years reveal some type of neoplasm, and slightly over 6% of these patients have advanced cancer, results of a nationally representative endoscopic registry show.

One Quarter of 30–49-Year-Olds Have Abnormal Colonoscopy Results – Medscape – Jun 07, 2021. — https://www.medscape.com/viewarticle/952536?src=rss#vp_1
APL = Advanced Premalignant Lesions. CRC = Colorectal cancer.

Also see Study Finds Sharp Rise in Colon Cancer and Rectal Cancer Rates Among Young Adults and Diet and Colon Cancer Risk – CBS News.

Colorectal Cancer Rates Rising in Ages 50-54

During the period 1992–2018, there were a total of 101,609 cases of CRC among adults aged 45–59 years. Further analysis showed that the CRC incidence rates rose from 23.4 to 34.0 per 100,000 among people aged 45–49 years and from 46.4 to 63.8 per 100,000 among those aged 50–54 years. Conversely, incidence rates decreased among individuals aged 55–59 years, from 81.7 to 63.7 per 100,000 persons.

Colorectal Cancer Rates Rising in People Aged 50 to 54 Years – Medscape – Nov 11, 2021 – https://www.medscape.com/viewarticle/962769?src=rss#vp_2

I am posting a link to this article as I enjoy the effects of 238 grams of Miralax mixed with a gallon of sports beverage and/or water. It certainly takes your mind off of not eating all day.

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.

SMH.

Any Polyp Type Raises CRC Risk

A finding of any type of polyp in the colon increases the risk for colorectal cancer (CRC), according to new findings from a large Swedish study.

At 10 years, the cumulative colorectal cancer incidence was 1.6% among patients with hyperplastic polyps, 2.5% among those with sessile serrated polyps, 2.7% for tubular adenomas, 5.1% for tubulovillous adenomas, and 8.6% for villous adenomas, as compared with 2.1% for the control group.

However, a higher risk for colorectal-related death was only observed in patients with sessile serrated polyps, tubulovillous adenomas, or villous adenomas.

The study was published online March 16 in Lancet Gastroenterology & Hepatology.

Any Type of Polyp Increases the Risk for Colorectal Cancer

Boldface sections are mine.

I had my first virtual visit with my physician yesterday.  I mentioned that I was postponing my colonoscopy this year for pandemic reasons.  She said that’s fine, don’t worry about it.  I read this article today.  Now I know why I’m on a three year callback.