I’m amazed to read that people were actually anesthesized for the procedure. The most I was offered is “conscious sedation”–and I felt nothing. I asked my gastroenterologist and he said using actual anesthesia that renders you unconscious is generally not recommended as the the risks from the anesthesia exceed the benefits. I imagine this als serves to push up the cost of the procedure.
Most people get propofol-it’s a step under “actual anesthesia” in that the patient breathes on his own, wakes up very quickly, and experiences very few side effects. With a competent anesthesia provider (MD or CRNA), the risks are few. This is done much more often these days during colonoscopy than conscious sedation, so I find the statement “is generally not recommended” strange, unless he is referring to the full blown anesthesia that people have with major surgeries where the patient receives gases, multiple drugs, and must be put on mechanical ventilation.
Not everyone who has conscious sedation has a pain free experience such as you had. Many people do not want to be aware of this kind of procedure. Glad yours went well.
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I didn’t read any previous posts, sorry if this is repeated. And this topic hit home for me.
My friend who is a doctor saying that the medical professionals are trying to lower the age to 45 for people to have colonoscopy exam. They’ve seen so many men and women in their 50’s with colon cancer and died from it.
My very very dear friend - she got diagnosed with stage 4 colon cancer in Mid October this year, apparently the cancer has already spread to the stomach lining when she was diagnosed. She died 5 weeks later because her body couldn’t handle the treatment. She was 49. Her death shook the entire town, she left behind a husband and 4 young daughters from 12-19 years old.
I am 48, I will ask my doctor what my options are.
@Nhatrang - The main problem with trying to get one earlier than 50 is most insurance companies won’t cover it yet unless you have some kind of family history that warrants earlier screening.
If you believe that you are high risk enough to start screening earlier than 50, you can do annual FIT, which is inexpensive. Then do the expensive colonoscopy if FIT finds blood.
Probably also coincidentally helpful for gastroenterologists to pay off their medical school bills.
https://gis.cdc.gov/Cancer/USCS/DataViz.html says that the new colorectal cancer rates in 2016 by age group were:
age rate/100,000
30-34 6.0
35-39 11.2
40-44 20.1
45-49 34.1
50-54 62.2
55-59 67.9
60-64 87.5
65-69 115.8
70-74 141.8
75-79 182.0
80-84 217.1
85+ 236.7
Of course, some people may have different risk levels based on own or family history.
The most recent (2016) colorectal cancer screening recommendation in the US is from age 50 to 75 for typical risk people (A grade) with individual decision from age 76+ (C grade): https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/colorectal-cancer-screening2 . Comparison between various screening methods is included.
But if a FIT test finds blood, then will the colonoscopy still be considered to be a free routine screening, or will it be considered to be diagnostic?
The test is never “free” in the US in any case. It’s just a matter of how it is categorized for insurance, and that in turn depends on the underlying policy or form of coverage. But someone is paying - it just might be the government or your insurance company rather than personally out of pocket.
For people with high-quality employer-provided insurance, or covered by Medicare, the distinction might not mean much. That is, in those cases for “preventive” you might pay nothing, and for “diagnostic” you might also pay nothing, or you might pay a modest co-pay or have some portion assigned to your deductible.
On the other hand, if you have a high deductible health plan, then the difference could be very significant – for example, if your deductible is $5000 then you might find it is indeed the difference between paying -0- or pretty much having to pay your whole deductible.
But what is the “cost” for a person like @consolation above, who had a clean preventive colonoscopy, and then 8 years out was diagnosed with Stage IV cancer? In hindsight it would have been better to have a combination of colonoscopy with FIT testing – no guarantee that the cancer would have shown up on the FIT either, but there’s a reasonable chance that it would have shown up sooner than year #8, perhaps before the cancer had progressed quite as far. (Obviously there is no way to put a cost on the health and quality of life of the individual).
The downside financial risk is that you might have a false positive on a FIT, which would mean that you could incur the costs of a colonoscopy that turns out in hindsight to have been unneeded. But the downside health risk is that you might have undetected cancer – because colonoscopies aren’t 100% effective, and in some cases, 10 years between testing is too long.
Keep in mind that false positives on a FIT are relatively rare, in comparison to “true” positives – situations where post-FIT colonoscopy results in a finding of precancerous polyps or actual cancer.
I think if you are in the situation of making that decision from a cost-benefit rationale, the first step would be to review your insurance to see what the actual cost differential might be, if any.
For the people who want to start screening before age 50, neither is likely to be covered, so the choice then would be out of pocket colonoscopy, or out of pocket FIT (x number of years) with the small possibility of out of pocket colonoscopy.
My husband is scheduled for a colonoscopy next week. His last one was less than 10 years ago but since they did nip a few polyps he is due earlier. The prep has completely changed from when he did it before. Used to be stuff they gave you to drink the night before (and I believe you could eat that day). Now all the prep stuff is over the counter (miralax and ducolax) and you basically don’t eat the entire day before. I think they have also expanded the time to avoid dark foods (red wine) and hard to digest foods (nuts, fruit skins, etc.) That restriction now starts 4 days before (instead of like 2 days before). He also must have a covid test the day before and I can’t wait with him (although I need to drop him off and pick him up as he is not allowed to drive after anesthesia.) They are also saying no travel for a week after (I think this is the same as before).
No travel? DH had his colonoscopy on January 15, and we flew from CT to CA on January 16. The doctor was aware.
DH had his colonoscopy on Feb 18. My mother died that evening. He was driving 250 miles to the funeral 2 days later.
H had his 3rd colonoscopy in 2.5 years on June 8th. We go out to town to a large facility, as do many from my city. I know of 3 people (including H) who have gone there to different doctors in the same facility in the past 6 months. All had a different prep procedure.
For this latest one, travel was not restricted, but they did not allow any support people in the office. You were able to use the restroom right inside if needed. (I needed) They took in him, took his temp, asked a bunch of questions and that was it. They called my cell when he was done and they wheeled him out. He said he was brought (masked) straight to his bed area. He was never in any kind of waiting room with other people.
I mentioned earlier on here that H had his first one at age 50 with no kind of history or symptoms. They found a laterally spreading tumor. It was precancerous, and the doctor said had he waited 6 months, it would have been cancer. Hence why he needed one 3 months later. Our insurance has never been good, but one fantastic item they did add a couple of years ago was follow-up screening for things like mammograms, colonoscopies are included as wellness & free. That saved us over $3K out of pocket. Or more likely, H would not have gone back for the follow up, which is why they added the benefit. Nobody was following up. His latest one is still considered wellness even though it’s < 10 years. If it follows the doctor’s recommendation schedule, it counts. And this one was mostly normal. He gets to wait 3 years until his next one.
Given his risk profile, will be doing FIT during years 1 and 2 as well (i.e. if FIT in year 1 or 2 finds blood, pull the next colonoscopy in sooner than year 3)?
@ucbalumnus Given they did not mention it to him or put it in their written results/finding letter, I would assume no.
Does anyone know if you do the FIT one year, will insurance cover a screening colonoscopy in another year or 2 (if it’s normally covered as a preventative service)? I had a FIT last year but am now kinda wishing I had just gone ahead with the colonoscopy but I have a high deductible plan.
@ClassicMom98, I was similar. I had my first colonoscopy a few weeks after I turned 50. They found a large precancerous polyp they said would have turned cancerous before long. I’ve had several tests since. I get to wait five years this time. Thank goodness, because I don’t “clean out” very well. I have to take extra steps for them to get a good look.
Had my first colonoscopy about a month ago. Two polyps were removed. A day in a half later I was in the emergency room because of bleeding. Was admitted to the hospital and lost enough blood that I had to have an emergency colonoscopy to stop the bleeding. The 2nd doctor stopped the bleeding and found a third polyp. Never heard a word from the 1st doctor.
Holy cow. @tomcats88: That stinks. If I were you, I’d contact the first doctor “just to make him aware.” Did the 2nd doctor say anything about the first??
The 2nd doctor had all the records of the first colonoscopy sent to his office. I’m done with the 1st doctor. Have to go back in 3 years. I keep hearing that this can happen, but couldn’t believe that it did.