Or scheduled colonoscopies and yearly stool testing to see if the next colonoscopy needs to be brought forward from the originally scheduled date.
Whoa, if you donât have to go through âsuper prep,â be thankful!! Itâs tough. 48 hours with no solid food. And you get to take more laxatives! 
If anyone has a history of colon cancer and /or polyps with or without a history of it - get genetic testing for Lynch disease. Itâs very common but highly underdiagnosed . If you know you have a history then they need to use a blue dye to catch the âflatâ polyps that are missed with a regular Colonoscopy. This does run in Jewish family lines and others. If any women had ovarian cancer and are having a Colonoscopy⊠Get genetic testing for Lynch first since ovarian cancer is associated with Lynch and then they can do the proper type of Colonoscopy.
@MaineLonghorn, what is superprep, and why did you have to do it?
Regarding the blue dye, there are some articles indicating that it results in fewer missed polyps, particularly flat ones.
https://scienceblog.cancerresearchuk.org/2017/01/18/live-from-inside-the-human-body-robots-blue-dye-and-bowel-cancer/
https://medicalxpress.com/news/2018-05-blue-dye-tablet-polyps-colonoscopy.html
https://www.cochrane.org/CD006439/COLOCA_does-chromoscopy-dye-spraying-improve-rates-polyp-detection-when-compared-conventional-colonoscopy
https://www.webmd.com/colorectal-cancer/news/20180522/adding-blue-dye-to-colonoscopy-may-boost-detection
Wouldnât using the blue dye (especially if the patient just needs to swallow a pill of it during the prep) for all colonoscopies (not just when Lynch syndrome or HNPCC is suspected or confirmed) be standard practice?
@ucbalumnus. Itâs not. Yes you would think it would be that easy. I have to have one soon and I am lynch positive with a strong family history. I couldnât even find a doctor at Rush Hospital in Chicago that used the dye. I am going to University of Chicago and there is a doctor that does research in this and has a lot of experience in it. Catching this early is very key and can be life savings.
@busdriver11, six years ago they found a precancerous polyp which they removed. The doctor mentioned I wasnât very well cleaned out, although I followed prep instructions exactly. I had another exam three years ago. No polyps, but they again said I wasnât prepped well enough and said I needed to come back in three years rather than five as a result. So this time I told them to give me better instructions!
With normal prep, you go about a day on clear liquids only and take two laxative pills and Miralax.
With super prep, you go two days on clear liquids only. The first day, you take two laxative pills and magnesium citrate (yuck). The second day, you take two more laxative pills and Miralax. I sure hope this does the trick!
Thanks for that explanation, @MaineLonghorn. I was also not that cleaned out, and given 3 years to do it again. Now I have my colonoscopy next week, but they didnât tgive me the super prep. I was going to do the low residue diet and maybe add extra liquid diet time. I did this a couple of weeks ago, was ready to start the prep, and the snow hit Seattle. Hard to go through that avoiding of fiber, but Iâm going to try it for 5 days again.
That super prep sounds tough.
@busdriver11, I would recommend you contact the doctorâs office and ask them for the super prep procedure. Stretching out the next exam to five years instead of three makes the effort worthwhile!
Okay, Iâll call. They kept trying to push me towards Golytely or Suprep (finally talked them into Prepopik), but maybe they have something helpful to say. I suspect I wasnât that well cleaned out last time because I eat a lot of fiber, nuts and seeds. Going to stay far away from that this time.
Rcvd my cologuard results - and they were negative - so good for 3 years. I would really encourage anyone at low or average risk, with no history of polyps, who does not want to do a colonoscooy to do cologuard. Most insurances cover it now and it is very simple.
I took DS to see his psychiatrist today, the guy I really respect and admire. I mentioned going for the test tomorrow, and he said, âI keep avoiding thatâŠâ So I lectured him! I told him weâre counting on his sticking around a long time and I expect him to go for a test soon.
https://www.uspreventiveservicestaskforce.org/Page/Document/RecommendationStatementFinal/colorectal-cancer-screening2#fig suggests that FIT-DNA (Cologuard) every three years compared to FIT every year has slightly less effectiveness at averting colorectal cancer deaths and gaining life years, but also slightly lower harms from subsequent colonoscopies that are indicated slightly fewer times.
One FIT-DNA is also much more expensive than three FITs.
Do people like him and yourself a favor and remind them that if they are not at higher risk, then the stool tests (FIT or cologuard) are acceptable, non-intrusive, alternatives.
Because as I keep posting â the most effective screening test it the one that the person will actually get.
And I really get the sense that people who are âavoidingâ screening probably for the most part simply are not aware that the stool tests are available â or of all of the statistical research showing that they come pretty close to colonoscopy in overall effectiveness for early screening. In other words, the accuracy of a single FIT test may only be around 75% (it gets better when repeated annually)⊠but the accuracy of a colonoscopy that hasnât happened because the person keeps putting it off is -0-.
Even if a person still believes the colonoscopy is better â or if they have had one in the past and have been told by their doctor to come back in 3 or 5 years and that is what they are putting off - they can go ahead and get a stool test done, with the intent of scheduling the screening colonoscopy down the line.
I think sometimes âlecturingâ a person about anything can have the opposite of the intended effect â it increases the psychological resistance and makes a person less likely to do whatever it is they are being told they have to do. Especially if they are already inclined to avoidâ because the emotions driving the avoidance really are stronger than the rational logic that comes with the lecture.
Anyone who has a malignant tumor should be getting genetic testing on the tumor these days, because it can indicate which courses of chemo or immunotherapy treatment are likely and not likely to work. If the tumor has mutation that causes dMMR, they should be tested to see whether the mutation is somatic or germline. If the latter, they probably have Lynch Syndrome.
I had a right-sided dMMR tumor that probably arose from a flat polyp, but thankfully genetic testing of my blood revealed that it was somatic. My oncologist remarked to me at some point that there is some possibility that the polyp wasnât seen during my colonoscopy but I didnât realize until following up on flat polyps due to @Knowsstuff 's post that that was what was likely going on. Thanks!
@Consolation. Well just got my confirmation of my first visit for my colonoscopy and I canât believe I am on a site actually talking about it. But Lynch syndrome is worth talking about to save lives. https://www.webmd.com/colorectal-cancer/news/20180522/adding-blue-dye-to-colonoscopy-may-boost-detection
Like why this is not standard I have no clue. Itâs so easy and effective to do. Well at least the person I am going to is a known researcher on genetic colon cancer. She only takes on people that have been tested positive with genetic testing. They have also all the latest toys to play with. World class facility⊠Hope they donât find anythingâŠ
@ucbalumnus â
I think the big difference between Cologuard and standard FIT is marketing strategy. And that probably ties into cost as well. No one is making much of a profit from FIT.
I do realize that the Cologuard has the advantage of DNA screen as well as the blood. (Which is not the same as the more specific DNA testing that @Consolation is advocating â I hope that no one is under the impression that the Cologuard would be a substituted for that).
But I think I am with you â still unconvinced that the Cologuard is a better test overall.
Well, both are free with most insurances, my dr recommended I do cologuard this year, Iâm satisfied that I have had both tests in the past year, both negative. And I didnât have to have a colonoscooy. Win win, as far as I am concerned.
This might be part of the reason (from the article you linked to):
Iâve read elsewhere that something like 99% of those smaller polyps (the little flat ones that the blue dye exposes) are not pre-cancerous. The risk of harm from a colonoscopy goes up dramatically if a polyp is removed during the procedure. Itâs still quite low risk overall, but when there is accidental perforation to the colon, it is much more likely to happen during the process of polyp removal. So back to risk/benefits â it may be that the use of the dye would increase the risks of adverse events during colonoscopy beyond the benefit gained from few lives that would be saved as a result of giving the doctorâs the ability to see and remove noncancerous small polyps.
In your case you said you are lynch positive with a family history of cancer â so certainly that would indicate that you are in the high-risk group that may very well benefit from the blue dye. Itâs just that there might be a very different weighting of risk vs. benefit for high-risk vs. average-risk patients.
@Knowsstuff Iâm sorry to hear you have Lynch. That can be tough. Have your family members in a position to have inherited it been tested? I turned out to have an inherited mutation that increases the chances of breast cancer, but apparently only in older women, and prostate cancer in men. I am assuming that I inherited it from my father, who had prostate cancer, while no one in my motherâs family had cancer at all. My son should be tested eventually, and my sister ought to be because she has four daughters. But so far she hasnât had it done. Her oldest D just went ahead and had herself tested. I think that her insurance covered it because of me, since I had to send her copies of my diagnostic reports.