Hacker News Reader

Comment by Redoubts | Hacker News Reader

> You may cause lasting harm to some of those 105 people.

Could you elaborate on this?

you will do surgery on some of the 105 people. Some of them might die from complications, infections, etc or at least have lasting damage. Since several of the 5 people will not be any better off with treatment it's entirely possible that the screening produces palpably worse outcome.

The earlier you screen, the worse this is, since the ratio of false positives vs true positives gets higher and higher, for example 1000 vs 5 or 10000 vs 5.

It's also psychologically harmful to have the positive test hanging over your head. I'm nearing the age where doctors start harassing about colonoscopies. You can do an at-home test instead of the full procedure, and it has a very good chance of ruling out the need for a colonoscopy. But it also has a high false positive rate; there's a decent chance that you'll end up in a state of "need a colonoscopy, also a colon cancer screener flagged you". I'm dreading the colonoscopy prep, but I'm not doing the at-home thing.

I've had colonoscopies twice. Was just half a day of inconvenience if you schedule it for the morning.

The scope, right? Not the at-home test? The only thing about the scope that bugs me is the prep.

I've been scoped twice and the prep sucks. It's shitting your ass out for half a day. On the positive side, getting sedated isn't half bad and you get the day off work.

I'm another one who's had two colonoscopies. Try to schedule it for the morning so that most of the fasting time will be while you're asleep. The prep is not a lot of fun, but it's only about half a day and it's very much not as bad as gastroenteritis or anything else that'll give you a good bout of diarrhoea.

And if you aren’t a fan of being sedated (I’ve never been, and I’d prefer to keep it that way), you can opt to do it without sedation. Had a colonoscopy and an upper endoscopy the same day, no sedation. A little uncomfy, but not painful. If you can push yourself through hard weight training sets, or run a 50k, or anything else that entails a bit of discomfort, a colonoscopy is no biggy.

For example you might do surgery on people who wouldn’t benefit.

Reply on news.ycombinator.com