> Basically nobody else is recommending colonoscopies to the entire population with no cheaper tests
I'm not sure if I understand what you're saying. Kaiser Permanente sends me a take-at-home colonoscopy test every year, and some light googling suggests the cost is $20-$89. I've never done an in-person colonoscopy, but the home version must be cheaper, right?
Unless you're putting a camera into your colon, it's not a colonoscopy
they're referring to a screening kit like this: https://www.cologuard.com/
That's not a colonoscopy. It's a colon cancer test, but not a colonoscopy, which, by definition, involves a scope.
Camera-pill?
Based on my personal experience with Kaiser and their home fecal test (FIT test) as a cheaper screening method, I suggest opting out of it and insisting on a colonoscopy.
The problem is that the fecal tests are totally inconclusive. Every positive test must be confirmed by a colonoscopy. And then you get into tricky waters with insurance. My Kaiser gastro doc insisted that my colonoscopy after a positive home FIT test would be billed as diagnostic and not covered at no charge as preventive screening. Which means I would pay over $2k. Despite the USPSTF publishing explicit guidance on this exact scenario still being screening. He was dead wrong, and I wasn't billed, but he and his department did everything they could to discourage me from following up with a colonoscopy.
And at one point he even turned the tables around on me and said this was all a consequence of my having opted for the FIT test instead of a colonoscopy. Which I never did, I was not given a choice. But from his statement I would assume that you can opt in to colonoscopy instead at Kaiser. Then again this could be yet another piece of misinformation on his part.
Kaiser has some very opinionated beliefs that their medical leadership pushes. From my partner's T2D issue (from no history to an ICU stay with DKA): "You cannot go into remission with T2D". "You will need to keep your A1C between 6 and 8 otherwise you will have issues with the medications you are on". They also have many medications they will not prescribe, regardless of the reason.
And don't start me on their pharmacy. She had root canals with some infection, and was in substantial pain. Dentist prescribes short term pain meds between procedures - she's in agony. I drive her from dentist to the Kaiser pharmacy at their UC/ER-lite/whatever facility, that I know from my previous work as a paramedic has pain management medications on site (day surgery, etc.)
"This is a pain management prescription. We do not fill those in person. You will need to submit it to our mail order." "How long will that take?" "5-7 business days, and then shipping time."
"Oh, look at you, coming from the dentist with verifiable surgical procedures done and in pain - just in case you might be drug seeking, you can hang on for a week or two and get your pain management then."
That last one is, I'd argue unethical and against most pharmacists "oaths".
I haven't heard of a take-home colonoscopy. How does that work?
The take home thing is a vial into which you put a stool sample and mail it back. Then it gets tested for signs of colon cancer. I've seen them advertised on TV as well.
That is not a colonoscopy. That is a stool sample and as other replies noted this gets sent out every two years to every one. In the UK from age 60 Australia seems to be from 50.
If that tests positive then you get a colonoscopy to check more things. If you have had colon cancer then you get a full colonscopy evry two years and an MRI every year.
Right, it's an alternative to a colonoscopy. As standard-of-care it's relatively new in the US.
No it is not an alternative to a colonoscopy it is a different test.
If this test finds something then the next step is not treatment it is you need a colonoscopy.
It is a test that cuts down on the number of colonoscopies needed and is cheap enough to find problems earlier than everyone having a colonoscopy which is just unaffordable,
I've got extremely normal marketplace health insurance and my doctor is at an extremely normal overworked large regional health chain, and I would have to argue with him to get an at-home test; the whole system is set up to funnel us all into colonoscopies.
Replace colonoscopies in that sentence by anything that can be made money from and pays doctors.
Sigh, we’re so far behind in anything that’s actually good for the common person. We’re way ahead in capitalistic societal development, though.
This is standard in Australia. Everyone between 50 and 74 receives a free kit in the mail every two years, and there are regular TV ads from the federal government (featuring actual TV stars) encouraging everyone to do the test and mail the results in.
The home version is cheaper, and inferior