[Hasz]

I have UC and will get colonoscopies to confirm it is well-controlled for the foreseeable future. It also increases risk of colorectal cancer, something I am actively thinking about. Rates of UC, IBD, and similar digestive issues are up across the board, also for a mixed and seemingly inscrutable set of reasons.

IMO, the fundamental issue for preventative screening is there is basically no amount of money I would not part with (of my money, the insurer's money, or private debt) to not die. I expect this is true for most people, and it makes preventative screening a tricky topic. In recommending screening for those >x age, you will miss some detectable, preventable and treatable cancer risk for those <x age, purely for cost. No one wants to be explicit about that though!

I think the only way out of that uncomfortable conversation is making screening so cheap via automation that you can basically run it for very low incremental cost as often as individual risk tolerance permits. This would be paid for on the back of earlier interventions vs late-stage, expensive interventions.

[voxl]

A colonoscopy is more than screening, if they see a polyp they remove it. Left alone that polyp will very likely eventually become cancer. Routine colonoscopies for someone with IBD is multi purpose, you screen for active disease, fistula, strictures, cancer, while simulatenously treating active disease (polyp removal)

Similar things happen in any general surgery, for example you can get your tubes removed and send up with all your endometriosis that you weren't able to diagnosis removed as well

[mhb]

> Left alone that polyp will very likely eventually become cancer

I don't think so. You have a reference?

[Findecanor]

You can't tell whether a polyp is cancerous or not before you have removed it, sent it to the lab and got the results back.

Therefore, all polyps should be removed. (Sending them all to the lab might be superfluous though)

[mhb]

Yes. That is the recommendation because "some" polyps are or may become cancerous. Not because all do. Unless you are saying that they do?

[voxl]

https://pmc.ncbi.nlm.nih.gov/articles/PMC9924026/

Though I regurgitate this information based off conversations with gastroenterologists not one off studies.

[mhb]

You claimed that "polyp will very likely eventually become cancer". I don't think this is true, in general, for polyps even though some might become cancerous. The paper you provided is pretty dense, but it didn't see to me as though it is saying that polyps generally become cancerous.

[voxl]

It's an internet forum, I didn't claim anything. And your doctor isn't going to first biopsy just a little bit of a polyp to determine if it's the "bad" kind, he's going to remove all of it.

It's annoying pedantry, a distinction without a difference.

[mhb]

Oh FFS. The difference between polyps very likely becoming cancer and some polyps maybe becoming cancer is not pedantry. And it probably wouldn't be as annoying to you if you just said that you didn't know instead of attempting to dig deeper by providing a source that you either didn't read or didn't understand.