If you are ages 50 or older, you’ve probably been recommended a colonoscopy as a way for early colon cancer detection. In the United States, it has been one of the more accepted cancer screening procedures around, aside from Mammograms. But now Canada is saying no to them, recommending against running the procedure. And it has a lot of people asking the question as to whether or not Canada is outright crazy, or on to something.
According to a new Canadian guideline from the Canadian Task Force on Preventive Health Care in CMAJ (Canadian Medical Association Journal), lower-risk adults between the ages of 50 and 74 should go in every two years to get checked out for possible colon cancer, but not using the traditional colonoscopy procedure. Instead, the new Canadian recommendation is FOBT, or fecal occult blood testing and Flexible Sigmoidoscopy (this one is every ten years). With Flexible Sigmoidoscopy, a flexible scope is used to view the lower portion of the colon rather than the entire tract. According to Medical Express, the colonoscopy’s benefits and track record have come under extreme scrutiny by medical professionals.
“Although colonoscopy may offer clinical benefits that are similar to or greater than those associated with flexible sigmoidoscopy, direct evidence of its efficacy from randomized controlled trials in comparison to the other screening tests … is presently lacking; however, ongoing clinical trials are working to address this research gap,” states Dr. Maria Bacchus, chair of the guideline working group and a general internist in the Department of Medicine, University of Calgary, Alberta. “Wait lists for colonoscopy remain long in Canada and have increased over the years.”ADVERTISEMENT
Colorectal cancer is a notorious killer amongst both men and women, and Canada is no stranger to that. In 2015, 9300 Canadians succumb to colon cancer. Colon cancer is also difficult to diagnose in it’s early stages as it often yields none or few symptoms.
More guidelines for Canadian physicians can be found at Canadian Task Force’s website (here).
Some have blamed Canada’s socialized medicine setup on this move, claiming the procedure is expensive to carry out. While others feel strong that Canada is right when it comes to a colonoscopy’s effectiveness. Cancer.gov attributes a 60 to 70 percent reduced death rate to colonoscopy procedures. Healthline.com makes a case for the effectiveness of colonoscopy alternatives.
One option is the fecal immunochemical tests, or FIT, which are approved by the Food and Drug Administration (FDA). It’s used as the first line colorectal cancer screening test in most of the world, including Canada, Israel, the Netherlands, Italy, France, Taiwan, China, South Korea, Scotland, and soon, England. It’s recommended as the screening test of choice by the European Union Guidelines.
FIT is a stool test and can be ordered by your doctor. There are different kinds of FIT tests, both wet and dry. Allison recommends you check to be sure your test has “evidence of its performance characteristic in large average risk populations and evidence of quality control over development and interpretation.”
Where do you stand?