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Comment by louprado | Hacker News Reader

I looked through your comment history to ensure you haven't already answered this. But what made you get tested ? Did you have risk factors ? No problem if you'd rather not share.

Related, I was told by a doctor to get screened after turning 50. But a reasonable self-estimate given all my risk factors puts my chances of having colon cancer at 1 in 10000. A colonoscopy has a false positive of ~2%[0] for my demographic. Meaning if I get a positive result, it's actually ~200 times more likely that I don't have cancer. It's hard to justify a screening given those odds and the 99%+ chance I will waste my time treating and worrying about a disease I don't have. My guess is an insurance company wouldn't cover a colonoscopy for those reasons.

[0]https://pmc.ncbi.nlm.nih.gov/articles/PMC7147410/

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I just had my first colonoscopy at 45 - they lowered the guideline recently, as the article mentioned.

The link you give is for colon cancer blood tests. Colonoscopies themself are basically definitive, because if they see something suspicious they will snip it and send it to the lab for biopsy. I had one such "suspicious polyp" and it turned out it wasn't a polyp at all, just normal intestinal tissue they mistook. There's your false positive. But the risks and long-term consequences are basically nil, the intestine heals itself in a week or two.

It's a very unpleasant procedure (the prep, not the procedure itself), but it's also very low risk and effective at catching colon cancer cases early when they can still be treated.

Here in France it's a bit different : everyone aged 50 or more is tested (blood in fecal matter) every 2 years. If the result is positive then it's colonoscopy. All this is paid by the Sécurité Sociale of course. I'm in between these 2 kinds of tests and currently crossing fingers.

>But what made you get tested ?

Tested at 37, because occasional bloody stool. Found a few polyps but no cancer. Still had to fight with insurance to keep my costs below $2500 for the whole experience. Still upset the doctor thought I was joking when I requested a DVD or Memory stick with the tour of my insides on it.

You can do a comparison to the UK, which, as I understand it, does not give out routine colonoscopies as the first line of defense, as in US. I believe there are some preventable colorectal cancer deaths there for this reason.

I asked my doctor here in the Netherlands about a test (mid 40's male, my dad has had several polyps removed) and he said to come back when I was bleeding out of my ass...

One thing I learned about colonoscopy is that it is not _only_ a test. I understand that the removal of polyps is a cancer-reducing mechanism in addition to being a diagnostic. Less invasive tests do not have this property.

Shortly after my 50th birthday I received a package in the post - a bowel cancer screening kit supplied by NHS Scotland - apparently I will now receive one automatically every couple of years until I'm 74.

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