Ha! I know two personally. If my brother had one earlier, he would have had polyps removed before cancer developed, not having to endure the torture he went thru to beat cancer, and not suffering from the after effects of those treatments years later. Or the volunteer fireman in my small farm town might be alive and raising his kids.
No, there has not been a blind study with a thousand people doing the fasting and laxatives every five or ten years, put to sleep, but given a dummy experience to pretend that they were examined as that would cruel.
Where did that come from? I didn't find it in either link you gave.
Nor that one.
Yes, that's an interesting study. I'd bet that it inspired a lot of discussion among the experts about its flaws. Like this one: "Healthy people between the age of 55 and 64 was randomized into two groups: One group was offered one screening with colonoscopy, the other was not offered screening at all. All the participants in the study were followed for over ten years, to see if colonoscopy prevents colorectal cancer." How dangerous is semantics? So a large group I assume was offered screening. We are left to wonder how many accepted screening. The big killer today is most people don't do stool tests or colonoscopies but wait until it's too late, like my brother and that TV actress.
That one seems to deal with facts better, but then I like the NYTimes. There is too much profit taking in US medical practices. I wonder what more recent studies have uncovered. Nine years is a long time in this field.
We don’t know for certian if your brother had a colonoscopy earlier if there would have been a better outcome. The polyps may not have developed yet, the prep may not have been sufficient, or the cancer may have already developed. For a single patient you never know, that’s why studies, preferably RCTs, with large populations are needed to make recommendations for the population at large.
As to the lack of benefit from colonoscopy, it’s been nicely broken down by Dr. Vinay Prasad.
“The chance of getting (diagnosed with) colorectal cancer in the invited group was 0.98% vs 1.2% in the usual care group. This represents an 18% reduction in relative terms, and an absolute risk reduction of 0.22% or 22 per 10,000.
The chance of dying from colorectal cancer in the invited group was 0.28% vs 0.31% in the usual care group. This 10% reduction in relative terms amounted to a difference in 3 in 10,000 and did not reach statistical significance.
In the invited group, 11.03% of patients died; in the usual care group, 11.04% of patients died.”
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.
sensiblemed.substack.com
So being invited to a screening colonoscopy (42% of those invited got screened) vs not being invited (and not getting a screening colonoscopy off study) results on basically no difference in outcomes. Virtually identical rates of cancer and virtually identical rates of death from all causes. So it would appear that being screened with a colonoscopy gets no better an outcome than not getting screened at all.
Here is the evidence that flex sig offers a reduction in all cause death.
“ Meta-analysis of all of the flexible sigmoidoscopy trials using the individual NORCCAP study cohorts shows that flexible sigmoidoscopy reduces all-cause mortality (RR, 0.975 [CI, 0.959 to 0.992]; P = 0.004; I2 = 0%) at 11 to 12 years (Figure 2). On the basis of the assumed risk for death in the U.S. population of screening age (50 to 74 years), the absolute risk reduction is 3.0 deaths per 1000 persons invited to screening (CI, 1.0 to 4.9) after 11.5 years of follow-up. Sensitivity analysis showed no important change in outcome with use of different random-effects estimators or exclusion of any single trial.”
www.ncbi.nlm.nih.gov
