Why are physicians not ordering annual Stool Tests?

[DandyDon]

We have doctors on SB, so if you'd like to identify as one and tell me, thanks.

Colonoscopies are rough, I know. I've done a couple when I should have done several over the years. They can catch colon cancer in the earliest stages when it's relatively easy to cure, but few do them. Stool Tests are easy tho, and can tell a person if they need to do a colonoscopy.

There's a volunteer fireman in my small farm town in his 40s with colon cancer, like my brother 30 years ago. We used to think it was a disease of the older folks, but maybe it was just missed before. It's possible in the 20s. They had a benefit today, $10 for BBQ sandwich, chips, and soda. I picked up four, delivered three to my brother's house, and we gave them $120. It was not good BBQ, but oh well.

I remember the hard times my brother went thru decades ago and they barely saved him. The after-effects of all the chemo and radiation he endured then are taking a severe toll on him now, but he's still with us, mostly. Some of the neighbors really pitched in then, driving him 75 miles to treatment and back every day so he could be at home at night while I took care of a few hundred cattle on wheat pasture alone even in blizzards. We did what we could, the cattle actually fared well under my care, and he survived. You'd think that we'd all learn from his problems and all give our colonoscopies every five years, but nope. One of the neighbors who helped the most didn't and then came down with colon cancer too, and I only did a couple. Many haven't at all. Colonoscopies are tough tho with the night before cleansing and all, as well as expensive, so I understand the challenge there.

But over-the-counter kits are available for home stool testing. The kits, available in most pharmacies, cost about $5-$35. The Colon Health Check Test is $35 and takes about five minutes to complete. The test screens for early signs of colon cancer and checks for blood in the stool. Professional labs offer stool culture testing services for about $40-$100. How Much Does Stool Testing Cost? - CostHelper

And everyone over 20 years old should get one yearly...!!

 

[brsnow]

I do colonoscopy yearly since mid 20’s they are pretty easy. They are also covered by insurance as preventative typically. If you do the stool example and then need a colonoscopy it is now treatment and billable vs preventative. That is how it was explained to me, but the at home test isn’t an option for me.

 

[Brant Emery]

The home test kits are not very accurate. A very high rate of false neg.& pos.

 

[Marie13]

There’s a prescription (??) version of the at home test that is apparently pretty good. It’s only recommended for those with no family history of colon cancer. My GP has ordered it and I’m waiting for it to come in the mail. Can’t remember the name of it. It’s covered by my insurance.

 

[brsnow]

The home kits will be covered but if you show positive they will set up a colonoscopy that will now be treatment instead of preventative, so it could get expensive from what had been explained to me.

 

[DandyDon]

I do colonoscopy yearly since mid 20’s they are pretty easy. They are also covered by insurance as preventative typically. If you do the stool example and then need a colonoscopy it is now treatment and billable vs preventative.

Wow, I guess you have personal reasons to do them annually. I'm glad think that they're easy. Interesting point on the insurance angle.

The home test kits are not very accurate. A very high rate of false neg.& pos.

I suspect that lab tests are surely better. One might think that they're better than nothing, but a false negative would be dangerous.

There’s a prescription (??) version of the at home test that is apparently pretty good. It’s only recommended for those with no family history of colon cancer. My GP has ordered it and I’m waiting for it to come in the mail. Can’t remember the name of it. It’s covered by my insurance.

The home kits will be covered but if you show positive they will set up a colonoscopy that will now be treatment instead of preventative, so it could get expensive from what had been explained to me.

That would vary with insurance coverage. Insurance should cover both, but how is this question.

Back to my original question...??

 

[Akimbo]

I believe that FIT (Fecal Immunochemical Test) is more widely used in Europe for screening than in the US. I found this interesting: A single FIT test detects about 73 percent of colorectal cancers. But because you use FIT every year, 10 screenings over 10 years make it just as good as one colonoscopy every 10 years

Cologuard claims to detect 92% of colon cancer overall by looking for genetic markers. A positive FIT or Cologuard test is followed up with a colonoscopy, which can collect tissue for biopsy.

 

[Marie13]

I believe that FIT (Fecal Immunochemical Test) is more widely used in Europe for screening than in the US. I found this interesting: A single FIT test detects about 73 percent of colorectal cancers. But because you use FIT every year, 10 screenings over 10 years make it just as good as one colonoscopy every 10 years

Cologuard claims to detect 92% of colon cancer overall by looking for genetic markers. A positive FIT or Cologuard test is followed up with a colonoscopy, which can collect tissue for biopsy.

Thanks! That’s the one my doctor prescribed. See at the top of the page that it is definitely prescription only.

 

[Ghost95]

The follow-up to a positive Cologuard test is a colonoscopy so just skip the middle man. Also the stool tests might not show precancerous polyps that would be easily removed during a colonoscopy.

I've gone through 2 Colonoscopies. Considering what you're looking to prevent, it's not that bad a process. Yeah, the solution tasted ick, your butt will be sore, and you might get cold but if it prevents a painful cancer death or nasty complications from diverticulitis then drink up, poop out, and enjoy the sedating drug ride. The newer anesthetic like propofol are amazing, short acting, and don't leave you hung over. But a friend told me... Don't drink champagne the day before even though it is a clear liquid. Makes for nasty side effects under anesthetist.

Yes, Dr's should make sure you get these procedures if you're 50+, have a family history, or are having issues. Most others tests that come back positive will be ground truthed with a colonoscopy. One test and done is easier in my opinion.

 

[Marie13]

Who wouldn’t pass up the opportunity to get roto-rootered?