Colorectal Screening

[janb]

I had a funny thing happen, I had a doctor’s appointment today. I always hate going to the window, “would you please fill out these forms and sign them.” I was handed two forms; a medical update and COLON AND RECTAL CANCER SCREENING FACT SHEET. I thought I would fall on the floor right there! I had to read and sign the disclosure on the back page. This fact sheet covered every aspect of how, when, where and why as it related to getting colon cancer. On the bottom of the second page were two boxes and I had to check one of the two:

I acknowledge that I have read this disclosure and understand its contents and that my clinician recommended one of the options discussed above.



Today I choose:

A test for blood in my stool, repeated 3 times Signed:________
Sigmoidoscopy
Air contrast barium enema
Colonoscopy

I decline the recommended screening and understand the potential consequences including undetected cancer and possible death. Signed__________

I said to my doctor “someone must have been sued.” He replied yes and shared the story. Basically, the person who sued had been told at every visit to get screened. On two occasions the patient came in to be treated for a cold and another physical ailment. Five years later the patient (who hadn’t been to the doctor in 5 years) was diagnosed with colon cancer. He won the case ($200,000) because there were two occasions in his lifetime that the doctor didn’t tell him about colon cancer screening (cold and other) and if he had discussed screening at either of those visits, he might not have it now. So now ProHealth Physicians educates every patient on colon cancer. It took a lawsuit to do it and I don’t agree with the settlement but the fact is that everyone in a ProHealth group learns about colon cancer and that’s a positive thing. I don’t know where this lawsuit originated, it wasn’t at his practice.

[Magnolia]

It's a bit scary to think that we have to discuss colon cancer screening with a patient who comes in for a cold. That, of course, means we also have to discuss mamograms, PAPs and about a dozen other things at EVERY visit no matter what for, and bill the insurance company for twice the time we really needed. And we wonder why heathcare costs are out of control. In a sane world we could save all that for the annual physical. Reasonable people should only need to be reminded once a year, provided they actually DO get reminded. I like the printed form idea, though. A handout with ALL the cancer screening tests and when they should be done could be given to all patients at check-in. They could read it while they're sitting in the waiting room. I don't like the "I choose" or "I decline" all or nothing tone of the form above. It sounds intimidating. My inclinaton, if I were a generally well patient, would be to choose
the fecal occult blood test, and get the heck out of there. I wouldn't commit to a colonoscopy on the spot. It takes a while to warm up to the idea. Rather than ask someone to commit or refuse, wouldn't it be better to give them take home info, have them sign an acknowledgement of receipt, and discuss it again at the next visit?

[Guest]

I think this form was a little harsh -- Maybe they need to hand out forms regarding the need for screening and have patients sign a form that they received the information.

It seems like a lot of us were misdiagosed and could of caught it earlier if one of the MD's suggested a colonoscopy.. We need to get the info out so everyone is aware. We need to be our own advocates.. Ask questions, do research yourself. We need to be in control. It is scary that there are so many people that say "Thats what the Doctor said to do", If it seems wrong or just not right -- get a second opinion or reach out to someone else for some info.. That is why this site is a great place for information.

Thank you everyone for taking time out of your busy schedule to give all of us valuable information. By us sharing our stories, we are able to help each....Thanks Cathy

[momof2crazyboyz]

I forgot to log in -- I was the about guest.

[Bryan S]

My mom had it and even though I should have started having colonoscopies at 40 my 2 previous dr's let me put it off. They tested for blood in my stool, but if you don't bleed you can still have a problem... New dr when I turned 50 insisted I have a colonoscopy and yes I had a tumor I also had no symptoms. Now do I go back and sue the 2 previous dr's for not insisting I have a colonoscopy? No it's my fault and as an adult I have to live with my decision. I can't even think I could sue someone because I said no, but I guess others can. It is a shame we have so many lawsuits over bad decisions that we have made. No one can force you to have a test but these days the Dr's all have to cover themselves because of all the attorneys wanting to sue everybody.

[Guest]

My mom died at 58 of CC and was dx'd at 54. When dx'd they estimated it had been there ten years as it was growing lengthwise not wider, so it took longer to cause a complete blockage. Had she had a colonoscopy at 50 , which for some reason is the AMA reccomended age to start the screening process... she very possibly would still be here celebrating her 61st birthday, which would have been today...
My point is, I started the screening at 31... I had my first colonoscopy at my request of a great gastro Dr who understood my rationale. I had my second one just last year... I will do them every 3 years.
You have to speak up and be your own advocate... the AMA is wrong, their data is outdated.... Ask for a screening and if you have to... tell the dr you have signs something is wrong....it's your life. Don't let your insurance company muscle you either and don't settle for an occult blood or a sigmoid... a colonoscopy is the only way to be sure. It's not fun, I can't lie, but it's worth the prep ( I use the fleet pre kit.. not terrible ) and the minor discomfort of the procedure... don't die of embarassment.
Erica

[MzApe]

Erica, I LOVE that! That should be the Colon Cancer Awareness slogan! Call the American Cancer Soc and submit that. It's awesome!!! Somehow everyone can talk about breast cancer - but colon cancer is embarrassing to talk about. Your slogan could help that! Great one!

[Magnolia]

The recommendation is for the average person to start screening at 50. People with risk factors such as symptoms or family history start sooner. The general rule of thumb for family history is to start screening ten years earlier than the age of the diagnosis of the youngest family member to be diagnosed. I think we could do better, but these are the guidelines we have now. Many of us can work with them if we use a little creativity. Unfortunately it doesn't always work. Like I said before, it just isn't feasible to screen every low risk, asymptomatic young person because of the very rare one who will have cc. The procedure itself can cause complications, some of which can be life threatening. Again I have to say persistant symptoms should never be ignored, regardless of age.
Maybe a virtual colonoscopy at age 30 would be a safe, if not inexpensive, alternative. As technology advances, maybe we'll come up with a safer, more cost effective screening test that can be used throughout life.