You May Not Need that Colonoscopy

53,000 Americans are expected to die from colon or rectal cancer this year

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I usually write here on topics of death and dying. I don't usually write on diseases that can lead to death. But we know so much about inflammation leading to diseases, and in particular the relationship between dysregulation of the gut and disease. I just can't not write about this today.

We can take the leap that an inflamed microbiome will result in problems downstream in the colon, or large intestine. Are you with me?

Colonoscopies are widely used, but there is another option available: fecal tests.

A colonoscopy is where a doctor inserts a colonoscope — a flexible tube with a video camera at the end — into the rectum and colon and looks for polyps and cancers to remove. The doctor may also take samples for study in a lab.

If no polyps or cancers are found, the average patient can wait 10 years before having another colonoscopy.

Fecal tests can be done at home. Patients collect a stool sample and mail it to or drop it off at a testing lab. The fecal immunochemical test, or FIT, should be repeated annually. A lab analyzes the sample for traces of blood, which can indicate a polyp or cancer. If blood is detected, the patient must have a colonoscopy.

One study found that after 30 years, people who had fecal tests had a 33 percent lower death rate from colon cancer than people who were not screened. A 10-year European study of colonoscopy found a 30 percent reduction in the risk of getting colon cancer. 

If one test is highly invasive with certain risks that are associated with inserting instruments into the body, and the other is simple and easy done in one's home, and both have about the same rate of success in identifying colon cancer, why isn't the fecal test considered best practice? 

The answer, of course, has to do with profits.

“Colonoscopy is a massive revenue generator for hospital systems,” said Dr. Adewole Adamson, of the University of Texas in Austin, who studies cancer screening.

I have never had to drink that awful colon-clearing liquid on the day before a colonoscopy. I have never had a colonoscopy. I have never been wiped out for a day or two after a colonoscopy.

Need I say more? I have had annual fecal tests for ten years. Ask your doctor about fecal tests. 

Stop the madness!