Colonoscopy vs Cologuard

[Dan Druff]

I am like you in that I hate the idea of being put under.

My concern about this was what had me putting off my first colonoscopy until I was just about 49, despite a family history of colon cancer which killed my grandmother and caused adenoma polyps in my father (which also might have killed him, if not for colonoscopies).

Sure enough, I had some bad looking adenomas in my colon in my 2021 colonoscopy, and I felt stupid for not having done it sooner. Fortunately they were caught in time.

Colon cancer is very hereditary. If you have no known direct family history (parents or grandparents) with colon cancer or colon polyps, you are much less likely to get colon cancer.

This is why they feel Cologuard is fine for those without an elevated risk, but bad for people like me who have a high risk.

I assume you do not have an elevated risk.

The good news is that Cologuard does not have a terrible false negative rate (8%). It DOES have a bad false positive rate -- 13%, last I checked! This means 13% of healthy people get Cologuard results indicating they might have colon cancer! Then you have to twist in the wind until you can schedule an receive a colonoscopy to verify. That would be awful.

The false negative rate of 8% is far higher than that of a colonoscopy, which is why it's not recommended for someone like me.

So if you're willing to tolerate the 13% false positive rate, as well as don't have a family history of colon cancer/polyps, you are probably fine doing Cologuard. It's not ideal, but you're not taking a huge risk.

In fact, colonoscopy is not risk-free. The biggest risk is NOT from the propofol, which is very safe. The risk tends to be from damaging the colon during the procedure, which can sometimes lead to death. For people like me, the risk is justified, as there's a much higher chance I will die of colon cancer than die from the colonoscopy. For someone like you, the risk is probably still justified (because lack of family history doesn't guarantee no colon cancer), but it's not as clear cut.

My mom has no family history of colon cancer. After several completely clear colonoscopies, they actually instructed her that the risk of the procedure was actually higher than the chance polyps would show up, and she was told to stop getting them, and do Cologuard instead.

No family history of Colon cancer. And I should have added that my Primary Care doctor said some new protocol for healthy people with no family history is to wait until 60. Just don't want to be put under without necessity. That being said, I will be put under in May when I have surgery on my shoulder, but I can't put off surgery any longer (it's been 2 1/2 years dealing with Frozen Shoulder, Torn Labrum.) Interesting enough, Shoulder doc says my Frozen Shoulder was caused by getting my Moderna booster shot. There are studies that are showing this data to be real, and he has numerous clients like me who claim their issues started when they got the shot. But he says it could also be caused by the Flu and RSV vaccines).

I don't want to get into a COVID vax dicsussion, because we already had enough of that here, but yeah, I laughed at the "safe and effective" shit in 2021. No way to determine that without long term study and data. I was well aware when I got my shots that I was taking a risk. I just felt the risk was less than the COVID risk, which was somewhat high in 2020-21 for my age group (which you're a part of, as well). So you still did the right thing by getting the shot (as long as it was in 2021, and not 2022), and just had a bad outcome.

I haven't heard about the age 60 thing for the colnoscopy with no family history. Maybe what they mean is something like Cologuard before 60, and a colonoscopy after 60. I do think it's probably close as far as the risk/reward with a colonoscopy before 60 with zero family history. For me, the colonoscopy was a no-brainer.

BTW I don't get any flu shots. The flu is not very dangerous to my age group. I really don't like risking vaccine side effects for diseases which aren't long term dangerous to me. When I'm over 65, I'll start getting the flu shot, as that's around when the flu starts to be able to kill you.