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Colonoscopy - the lesser of two
evils!
A colonoscopy is a procedure in which a doctor (it had
better be a doctor) takes a long and presumably flexible
tube and inserts it into your colon, and for those of you
who've never had one and are wondering from what direction
they get in, let me assure you that there is only one way
in. South, and then north.
"But why would anyone want to do that to me?" some
may ask. Because the colonoscopist wants to take a look
around your colon, not, I assure you, because he likes the
view but rather because he wants to detect any growth before
it turns into cancer. Luckily, most colon cancers start as
precancerous polyps or adenomas, and if a doctor can find an
adenoma and snip it, that greatly reduces your risk of colon
cancer.
Because a colonoscopy involves a direct look at the bowel
lining, over the last few years, these procedures have
become the favored tool in most centres for finding
adenomas.
But some Luddites still lurking about in the medical biz
have long argued that the newer and more costly
colonoscopies are really no improvement over the older and
less costly way of finding adenomas, namely the hated barium
enemas, surely the most avoided and postponed X-rays in our
arsenal. "I can't have a barium enema next week, Art.
It's 9 weeks before my cat's half-birthday."
Well, the debate has now been settled, I'm happy to say, and
the colonoscopies won over barium enemas hands down. In a
study published in the New England Journal of Medicine,
researchers directly compared colonoscopies against barium
enemas in a high-risk population, and colonoscopies came out
way ahead of barium enemas, not only in detecting adenomas
of all shapes and sizes, but especially at finding the
smaller ones.
In fact, barium enemas were deemed to be so poor at
detecting adenomas and polyps that the researchers concluded
that, if there is any choice in the matter, if, in other
words, you don't have to scrape bottom with your screening
choices, barium enemas should not be used as screening tools
for detecting colon cancer; a view, I'm afraid, that has
surely bummed out the medical Luddites even further.
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