I’m 40 and just had my first one because my dad died of colon cancer in his 60s. I didn’t even have a polyp and he said see you in three years. I’m like, nah. Maybe ten. If that.
Now THIS is the type of content we need. Love your pontification but not overly so. Would love Ashish Jha do hand to hand with you instead of one sided echo chamber
*this is so wild; i get my colonoscopies at IKEA!* small world. i only get them bc insurance covers it & it is cheaper than a colonic & a tarot reading, my old routine. fills a day. & one b4. & one or two after. _JC
I am of the age for a colonoscopy. Should I do the traditional or a CT scan or MRI? I also need an ultrasound of my liver. Would these kill more than one bird with one zone? The colonoscopy scares me and I don’t want to be sedated it won’t do it awake.
You don't have to be sedated if you don't want to be. Most people choose sedation. The procedure can be painful - especially for women, for reasons of physiology.
Intention to treat deals with attrition, but including those who recieved the mail but did not call back and did not give informed consent to any participation?
my uncle just found cancer cells in his prostate and dr’s have been taking forever for results. who/what should i point him to for info on recommendations?
@@ArtU4All Thanks. I looked up a few papers on this. I see it's a "kind of batting average" for scoring docs' polyp-clipping rate related to GI-center improved earnings. Scary!
I disagree with the fact that the USA somehow has artificially elevated their ADR because its a quality metric. You cant artificially find more adenoma polyps! If you're finding more, its because you're doing a better exam and a better job of looking for them
New England Journal of Medicine - here’s the cite: Bretthauer M, Løberg M, Wieszczy P, et al., for the NordICC Study Group. Effect of Colonoscopy Screening on Risks of Colorectal Cancer and Related Death. NEJM; Published online 9 October 2022. DOI: 10.1056/NEJMoa2208375
Serum "Vitamin D" (cholecalciferol) levels have certainly been shown to be inversely associated with colon cancer risk (c.f., Gemma Ferrer-Mayorga et al., "Mechanisms of action of vitamin D in colon cancer"), but technically "vitamin D" is not a nutrient (although, as with phytoestrogens, "vitamin D" analogs can be found in large concentrations in certain foods), since it is derived endogenously (in the epidermis) from 7-dehydrocholesterol as a function of sunlight (UVB) exposure.
Yeah we know that red and processed meats increase your risk but let’s say your lifetime risk is 2% and it increases it to 2.5%. Is that enough to worry about? 🤷🏽♀️
What is “fit”? I only ask because I had an upper GI done in the hospital and now the doctor is telling me I MUST have a colonoscopy due to being 51 yo with family history of paternal grandmother dying from colon cancer. I have no symptoms.
Dr. Prasad, I would submit that you're at risk of doing more harm than good if you continue to ignore the fact that many people in your audience won't pick up on the fact that you're focusing on screening colonoscopy as opposed to diagnostic colonoscopy. More generally, have you considered using the phrase "evidence-based public health" (since screening falls in the category of secondary prevention, as in "Centers for Disease Control and *Prevention*) rather than "evidence-based medicine" (which sounds like something that should be taught in medical school)? P.S. Power calculations have nothing to do with minimizing the potential for bias from having a non-representive sample.
Hey buddy, I have noticed this. There has been a large attempt to discredit this study because it’s being misconstrued as diagnostic colonoscopy. I think you’re absolutely right we should take more to emphasize this is about “screening colonoscopy”
As always Vinay, you clarify all these important topics for us non-medical listeners. Thank you for all you do… you are wonderful. I am a real fan!
Excellent interview. I really enjoyed hearing the perspective from a physician located outside of the US. Keep up the good work, Vinay!!
I’m 40 and just had my first one because my dad died of colon cancer in his 60s. I didn’t even have a polyp and he said see you in three years. I’m like, nah. Maybe ten. If that.
What is a good reply? “Corrupt much?”
Vinay. I can understand your slower speech today. THANK YOU!
You can also change the speed of the video.
Now THIS is the type of content we need. Love your pontification but not overly so. Would love Ashish Jha do hand to hand with you instead of one sided echo chamber
51:20 helpful breakdown of risk/benefit from here to end.
reasonable people discussion. thanks
I am so glad I found this channel.
Fantastic discussion
Why can’t you do the full bowel clean out before a flex sig? Seems like a good compromise.
44:30 re pancreatic cancer screening: circulating tumor cells?
PET scan?
Let's talk about about the research revealing how the process shifts crucial gut flora in the wrong direction, and may not return to its normal state.
How what process?
Colonoscopy prep@@carloscontreras3633
*this is so wild; i get my colonoscopies at IKEA!* small world. i only get them bc insurance covers it & it is cheaper than a colonic & a tarot reading, my old routine. fills a day. & one b4. & one or two after. _JC
I am of the age for a colonoscopy. Should I do the traditional or a CT scan or MRI? I also need an ultrasound of my liver. Would these kill more than one bird with one zone? The colonoscopy scares me and I don’t want to be sedated it won’t do it awake.
As a layperson, I get confused by health policy. Vinay has rescued me.
Can you shed some light on why we have to be sedated for colonoscopies in the US?
So one can't get up off the Table and Run Away.
Less likely to remember hearing "Whoops."
Can be physically uncomfortable to have gas insufflated into large bowel. And fear of that sensation is what leads many to request anesthesia.
Money
You don't have to be sedated if you don't want to be. Most people choose sedation. The procedure can be painful - especially for women, for reasons of physiology.
Intention to treat deals with attrition, but including those who recieved the mail but did not call back and did not give informed consent to any participation?
Pediatricians get incentives for childhood vaccines.
? They pay to purchase the vaccines and syringes, so yes they do charge for them. CVS and Walgreens do the same.
@@HappyLife-wv5ms no no, incentives per year.
@@gardenvariety-so they get some sort of reward for helping the community have all their children vaccinated.
my uncle just found cancer cells in his prostate and dr’s have been taking forever for results.
who/what should i point him to for info on recommendations?
What is ADR?
Adenoma detection rate.
I googled it.
@@ArtU4All Thanks. I looked up a few papers on this. I see it's a "kind of batting average" for scoring docs' polyp-clipping rate related to GI-center improved earnings. Scary!
I disagree with the fact that the USA somehow has artificially elevated their ADR because its a quality metric. You cant artificially find more adenoma polyps! If you're finding more, its because you're doing a better exam and a better job of looking for them
The more you look, the more you find!
@@HeyYall398 right, which is the whole point of the test!
In what journal is this study published?
New England Journal of Medicine - here’s the cite:
Bretthauer M, Løberg M, Wieszczy P, et al., for the NordICC Study Group. Effect of Colonoscopy Screening on Risks of Colorectal Cancer and Related Death. NEJM; Published online 9 October 2022. DOI: 10.1056/NEJMoa2208375
NEJM
@@darthweezie thanks
I heard you say diet has nothing to do with colon cancer. I disagree.
Serum "Vitamin D" (cholecalciferol) levels have certainly been shown to be inversely associated with colon cancer risk (c.f., Gemma Ferrer-Mayorga et al., "Mechanisms of action of vitamin D in colon cancer"), but technically "vitamin D" is not a nutrient (although, as with phytoestrogens, "vitamin D" analogs can be found in large concentrations in certain foods), since it is derived endogenously (in the epidermis) from 7-dehydrocholesterol as a function of sunlight (UVB) exposure.
Yeah we know that red and processed meats increase your risk but let’s say your lifetime risk is 2% and it increases it to 2.5%. Is that enough to worry about? 🤷🏽♀️
@@idunsgardenI disagree that meat increases risk.
The prof's name is Bretthauer (no s). And advise not advice. You should give a link to the paper - TH-cam won't allow links in comments.
Who cares about how the doc feels about procedure? Patient is first.
I hate to say it but it seems to me like this has become a political argument the US. seems to me that it aligns with ideas on covid policy 😂
What is “fit”? I only ask because I had an upper GI done in the hospital and now the doctor is telling me I MUST have a colonoscopy due to being 51 yo with family history of paternal grandmother dying from colon cancer. I have no symptoms.
Fecal immunohistochemistry.
It stands for Fecal immunochemical test
Dr. Prasad, I would submit that you're at risk of doing more harm than good if you continue to ignore the fact that many people in your audience won't pick up on the fact that you're focusing on screening colonoscopy as opposed to diagnostic colonoscopy. More generally, have you considered using the phrase "evidence-based public health" (since screening falls in the category of secondary prevention, as in "Centers for Disease Control and *Prevention*) rather than "evidence-based medicine" (which sounds like something that should be taught in medical school)?
P.S. Power calculations have nothing to do with minimizing the potential for bias from having a non-representive sample.
Hey buddy, I have noticed this.
There has been a large attempt to discredit this study because it’s being misconstrued as diagnostic colonoscopy. I think you’re absolutely right we should take more to emphasize this is about “screening colonoscopy”