Could be a racket to charge insurance co's for colonoscopy's??I did one and it came back positive. Very scary time until I had a real colonoscopy and it came back as everything AOK. Their false negative is about 8% and false positive is 12% and goes up with age.
My Kaiser doc is tight ass about colon cancer screenings. At one time I think he recommended one stool test a year, but I had to remind him. I had a couple colonoscopies with Kaiser and got my doc to promise me he'd set me up for another in 5 years but when it came time he wouldn't (I've had polyps in the past and my gastro-enterologist said every 5 years.)! I said "you promised!" He said "what am I going to tell them sending a guy your age for a colonoscopy?" I'm thinking of changing doctors! I'm younger than Biden and he just had one.No negative experience here over the past 9 years. I'm on an HMO plan so they've done the math on cost/efficacy. If you are in the no-family-history of colon cancer category, the annual stool test is as good as a once every 5 year colonoscopy, according to the metrics used by Group Heath of Washington, now Kaiser Permanente.
Although a mix of both tests is probably the wiser course.
A fair bit to unpack here, but suffice it to say, a big problem with American Healthcare is this idea that "more testing" is better.@Muse I recently had a physical because I needed clearance for a minor outpatient procedure. So I chose to see the first person available...a young Physician's Assistant. During the course of his exam he listens to my heart, pays real attention, and notices a heart murmur that no one else has heard since I was diagnosed with it as an infant...60 years ago. So I get an EKG and an ECG. I mention to the EKG tech how impressed I was with the PA, she says, "Oh yeah, he's the best. We send patients to him whenever we have a question."
Your primary is too uptight. I'd try communicating with him by the message portal...sometimes the written message, which is more formal, gets the required attention and forces your PCP to cover his arse. Kaiser is all about jumping through hoops and checking boxes, unless you self-advocate. The next time I go in I will be seeing the new PA if he is still at the local clinic.
He's been my only PCP since I got on with Kaiser Permanente. He right away made a play for me, saying he planned to stay with them and I could look forward to that stability. He came recommended by a couple of women who worked with him who were friends of my sister, so I figured he had to be good. He knows his stuff, is my impression. But I have always figured him for a guy who plays Kaiser's game, won't go out on a limb and buck their standards. But he did break that promise and he's been overly stingy with other stuff too.@Muse
Your primary is too uptight. I'd try communicating with him by the message portal...sometimes the written message, which is more formal, gets the required attention and forces your PCP to cover his arse. Kaiser is all about jumping through hoops and checking boxes, unless you self-advocate. The next time I go in I will be seeing the new PA if he is still at the local clinic.
I had the same experience last fallI did one and it came back positive. Very scary time until I had a real colonoscopy and it came back as everything AOK. Their false negative is about 8% and false positive is 12% and goes up with age.
So, colonoscopy is best. They actually go in there and look. I had IIRC at least 2 sigmoidoscopies before I had a colonoscopy. That's the same except that they don't go all the way up into the small intestine, they go in less far. If they find something then, I believe, they figure next time do a colonoscopy. I had a couple polyps at least one time.I had the same experience last fall
I did one and it came back positive. Very scary time until I had a real colonoscopy and it came back as everything AOK. Their false negative is about 8% and false positive is 12% and goes up with age.
So, colonoscopy is best. They actually go in there and look. I had IIRC at least 2 sigmoidoscopies before I had a colonoscopy. That's the same except that they don't go all the way up into the small intestine, they go in less far. If they find something then, I believe, they figure next time do a colonoscopy. I had a couple polyps at least one time.
It's a nuanced answer, but short version is the "value" of Cologuard falls dramatically after a positive result.I a positive Cologuard test once so had to do the colonoscopy anyway. I was told once i had the colonoscopy i coudn't do a Cologuard test again. Anyone know if that's true?
No a big deal really as it wasn't as bad as some people make it out to be.
Not common, but happens.They gave me pill laxatives...two bottles of the fuggers. And now I'm told they didn't work and weren't able to complete the colonoscopy ...so I get to do this all over this time with a liquid laxative..and shite and shite all over again. This happen to anybody else??
wondering why it has a high false positive rate?? the gastrologist I went to was massively over booked with follow up testing due to false positive outcomes...Cologuard looks for changes in your DNA that could indicate the presence of colon cancer . you have to take care of health
Because Cologuard detects DNA of colonic neoplasia AND for blood. The false positives are likely positive blood that was related to something other than cancer.wondering why it has a high false positive rate?? the gastrologist I went to was massively over booked with follow up testing due to false positive outcomes...
DNA-based colorectal tests have no history of data to call them reliable. You can use it, but don't do that instead of any other screening. Make sure you are having a conversation with your doctor so that you can understand the risks of any colon screening options you have so that you can make an educated choice.
Where is your research to back that up? Any current research I find indicates it should not be relied on as the only test.Well this is just wrong.
A major advantage of fecal DNA tests as compared to either FOBT or colonoscopy is the fact that they are not affected by proximal location of tumors[32,33]. Another advantage is the lack of need for purging or dietary changes.
However, the sensitivity of fecal DNA tests appears to be lower for adenomas when compared to CRC detection (Table (Table1).1). In addition, although there is evidence of reductions in CRC incidence and mortality from randomized controlled trials of fecal occult blood test (FOBT) screening[34], similar data are lacking for fecal DNA tests.
Other technical difficulties may involve the burden of large volume stool collection and shipping for the patients undergoing screening[31]. In addition, the fact that in the latest study of Imperiale et al[17] the DNA tests had over twice as many abnormal results as FIT, with a higher rate of false-positive results implies that more colonoscopies would be needed to further evaluate for CRC in the former arm. Thus, the inevitably higher number of diagnostic testing would increase the costs and risks of screening. Only with the current screening method of gFOBT, 690011 colonoscopies for false positive screening tests result in an additional estimated annual cost of £800000000[19].
Cost-effectiveness per se seems to be a major disadvantage of fecal DNA tests as both older and newer studies, particularly based on a Markov model, have concluded that fecal DNA is cost-effective only when compared with no screening, but is essentially dominated by most of the other available screening options, including FOBT and colonoscopy[36,37]. This may necessitate the limitation of number of DNA markers to render their clinical use more reasonable[38].
Where is your research to back that up? Any current research I find indicates it should not be relied on as the only test.
Fecal DNA testing for colorectal cancer screening: Molecular targets and perspectives
STRENGTHS AND LIMITATIONS OF FECAL DNA TESTS
I didn't suggest there is no data to support MT-sDNA. I stated "no history of data to call them reliable" and based on both studies they call out the issue of false positives with MT-sDNA, thus they are unreliable. Do they make sense in some cases, sure and the false positive rate is generally below 20% which may mean it's worth doing this test vs a colonoscopy which has some clear risks that the MT-sDNA test does not have. The importance is to make it clear to those patients the risks so they can balance them personally....suggesting that there's no data to support MT-sDNA is just wrong.
I didn't suggest there is no data to support MT-sDNA. I stated "no history of data to call them reliable" and based on both studies they call out the issue of false positives with MT-sDNA, thus they are unreliable. Do they make sense in some cases, sure and the false positive rate is generally below 20% which may mean it's worth doing this test vs a colonoscopy which has some clear risks that the MT-sDNA test does not have. The importance is to make it clear to those patients the risks so they can balance them personally.