Man having colonoscopy
“I’m not going to send you for a colonoscopy,” my primary-care doctor said. “We don’t do that anymore for people once they turn 70.”
When I asked why, she said the risks weren’t worth the benefits.
I’d read reports from alternative doctors that the risks were greater than mainstream medicine claimed, but this was the first time I’d heard it from a mainstream doctor, albeit a young doctor with a blessedly open mind. So I did a little research.
The Couric cure
On the website GutSense.org, medical journalist Konstantin Monastyrsky responded to TV personality Katie Couric’s famous admonition in 2000 that people over 50 should have regular colonoscopies to screen for colon cancer, which, she said, would result in a 90 percent cure rate.
Katie Couric
“Actually, this is a lie!” Monastyrsky wrote. “Screening colonoscopies do not prevent or materially reduce anyone’s risk of colorectal cancer regardless of age. And if anything, they may actually increase your overall risk of cancer, and not just colorectal.” The journalist is a performance nutrition consultant, and claims to be an expert in forensic nutrition.
He advised stool testing instead, and said that if indications of cancer turned up, the patient definitely should have a colonoscopy. To prevent cancer, he recommended a good diet to reduce the chances of colorectal disorders.
Parsing polyps
Monastyrsky said colon screenings were “pointless and dangerous” and claims to the contrary were a “whole charade” because: “almost all polyps are benign; removing them is riskier than leaving them alone; more than half of all polyps are undetectable; most cancers don’t start from polyps but lesions; you are likely to die from old age before colon cancer strikes you; and your risk of dying from colonoscopy-related complications may exceed your risk of ever getting colon cancer in the first place.”
Butt-ressing the doubts
His essay referenced 16 medical professionals, such as the National Cancer Institute: “It is not yet known for certain whether colonoscopy can help reduce the number of deaths from colorectal cancer.”
Patient undergoing colonoscopy
From A Cancer Journal for Clinicians: “There are no prospective randomized controlled trials of screening colonoscopy for the reduction in incidence or mortality of CRC (colorectal cancer).”
He quoted the New York Times, which reported on a series of studies, “The patients in all the studies had at least one adenoma (benign epithelial tumor) detected on colonoscopy but did not have cancer. They developed cancer in the next few years, however, at the same rate as would be expected in the general population without screening.”
And the prestigious Annals of Internal Medicine had this to say: “A goal of avoiding all deaths from colon cancer may be admirable, but we do not have evidence that we can achieve it.” Further, “Colonoscopy is an effective intervention, but … we must realize that current evidence is indirect and does not support a claim of 90% effectiveness.”
Scope of risks
colonoscope
Then there are the risks associated with colonoscopies. The Health Sciences Institute said, “Colonoscopies have ballooned into a $10 billion industry – but they’re by no means simple procedures.” HSI cited the National Cancer Institute, saying “serious complications or even death from this procedure can be estimated at 70,000 patients a year.” The complications include lacerations, perforated intestines, massive bleedings, even heart attack, plus bacteria transmitted by endoscopes used in the procedure.
The Journal of the National Cancer Institute reported on the concerns of Steven H. Woolf, M.D., professor of family practices at Virginia Commonwealth University in Fairfax, who said: “Neither the accuracy studies, nor the cost-effectiveness analyses address whether there is more benefit than harm.” The procedure causes an uncertain number of bleedings and perforations, Woolf said, and “you have to ask whether it is ethical to expose patients to those harms.”
Monastyrsky quoted the American Cancer Society: “Colonoscopy can result in significant harms, most often associated with polypectomy, and the most serious complication is postpolypectomy bleeding. Another significant risk associated with colonoscopy is perforation.”
Virtual colonoscopy
Even more dangerous than the conventional colonoscopy is the virtual colonoscopy, the journalist said, citing the FDA as saying the dosage from this computed tomography is “not much less” than the amount of radiation absorbed by some survivors of the atomic bombs dropped on Japan.
Couric compromised?
colonoscope
Monastyrsky noted a conflict of interest in Katie Couric’s televised colonoscopy and advocacy of colonoscopies. She “began urging Americans to get screened for colon cancer while she was employed by General Electric, the owner of NBC Television,” he wrote. “GE happens to manufacture and sell CT scanners used for virtual colonoscopies,” each costing around $3.5 million. Before Couric’s TV event, an estimated one million people were having colonoscopies. By 2007, that number had reached 14 million. Follow the money, the journalist says.
HCI insists that American doctors order almost twice as many colonoscopies as all of those in Europe, where the cost is a few hundred dollars, compared to charges ranging from about $6,000 to $20,000 in the United States.
“All for a pointless probing,” said HCI.