I personally want all of my patients (age 45-75) to be screened properly for colon cancer. This isn’t because of the insurance requirements, but because I understand we very often win the cancer battle when it is caught early and we almost NEVER win when cancer is caught late. I don’t ever want to see one of my patients suffer from something that could have been prevented.
As an Army veteran, I truly appreciate your right as an American to refuse colon cancer screening. It’s a free country and I’ve really sacrificed time away from my family and practice to keep it that way. A caveat here is that there is enormous pressure from insurance companies on the way that I practice. I’m heavily penalized if my patients don’t meet certain quotas for cancer screening. This is not an “incentive reward” for me as a doctor, rather a harsh punishment if my patients don’t comply with insurance company standards. If you don’t want to get colon cancer screening done, I respect your right to choose not to do that. You also need to respect my right to then discharge you from my practice. You will be discharged from my practice if you do not follow through on one of the following 3 options.
1) Colonoscopy is a procedure that uses a camera to directly view the colon. This requires a laxative preparation the day before, then someone to drive you to and from the procedure. The camera is inserted through the rectum so that a doctor can directly see your colon. The advantage of this procedure is if you have a problem, the doctor can often address it right then and there (removing a precancerous polyp for example). The disadvantages of this procedure are the laxative prep, the time the day of the procedure, plus the (VERY rare) chance your colon could be injured during the procedure. Most colonoscopies are good for 5-10 years.
2) Cologuard is an at-home stool sample test that looks for blood and DNA in your stool. It does a great job at detecting whether or not there is an abnormality in your colon that could lead to cancer. The advantage is that it is very easy - no prep, done at home and they make it very easy to return the specimen. The disadvantage is it only tells us whether or not you have a problem in there. If it says no, you can repeat a cologuard in 3 years. If it says yes, you then need a colonoscopy to determine if that problem is benign, precancerous or cancerous. Cologuard is only for people who have no history of colon cancer in their parents or siblings, or people who have never had a precancerous polyp in the past.
3) Fecal immunochemistry is an at home stool sample test that looks for blood in the stool. It’s easy, but doesn’t give much information and again if it is abnormal it then requires a colonoscopy. The other disadvantage is that you have to do this every single year. I generally recommend #1 or #2.
Please call the office if you wish to schedule an appointment to talk to us about these options.
This website is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional services, including the giving of professional advice. There is no doctor-patient relationship formed. The use of this information and links is at the user’s own risk. The content of this website is not intended to be a substitute for professional medical advice, diagnosis or treatment. Users should not disregard or delay obtaining medical advice for any condition they have, and should seek advice from their medical professionals for any of their medical conditions.