Even the screening rates in the U.S. would skyrocket. Who doesn't know someone who's put off a colonoscopy? They're really not that bad once you get the hang of them (even the prep), but most people don't do them often enough to get good at them, so they dread them more than is really necessary.
As someone who's had enough of them to have a favorite flavor of prep solution (lemon gavilyte-c, which tastes to me like a very mild lemon meringue), a couple tips:
1. Mix the solution with HOT water 12 hours before you need to drink it, and then refrigerate for the 12 hours. This way it doesn't taste salty.
2. For your "clear liquid" diet, drink bone broth with avocado oil in it, alternating with some coconut water. Get some protein and fat calories in you so you're not starving and not spiking your blood sugar all over the place. If I add 50% to my regular calorie intake, I'm not even really noticeably hungry.
Who even gets colonoscopies anymore?
Everyone I know just poops in a box and mails it to a lab nowadays.
Then you catch it quite late with current techniques. Hopefully in the near future it will be super accurate and something you can just do at home.
Those aren't highly accurate. I think they just detect blood in the stool, which could come from one of several causes including simple haemorrhoids. If you pop positive on your ColoGuard you're expected to come in for a colonoscopy.
not blood, but the DNA of cancer cells. really.
Those tests have a fairly high false positive rates. Hemorrhoids for example can cause a false positive, and are pretty common in people over 50 in the US.
Once you get a positive, even a false positive, health providers tend to try to switch you from an annual poop in a box test to whatever the normal colonoscopy schedule is at your age (e.g., every 10 years unless your previous colonoscopy found something that calls for a shorter interval to the next one).
Poop in a box detects pretty far along cancer - bleeding into the gut. Colonoscopy finds it a lot sooner.
Except that not enough people are getting colonoscopies, and the cost and time is significantly more (for both the patient and the medical team).
In Australia, at 50, everyone is given a poop stick which we send to a lab for results. I think one comes in the mail every 5 years if your previous result was negative.
Will try your tips next time. (omg, the salty is enough to stop me in my tracks!)
I've found reducing solid food a couple of days before the prep helps as does using diaper rash creme before you start the prep, all the way until you get the colonoscopy.
Also, grab some chux or plastic/garbage bags for the drive to the procedure and bring with an extra change of pants.
The saltiness goes away if you leave it long enough! I don't know why it takes so long to resolve, but it's really not bad at all this way.
Still not something I'd order off a menu at a restaurant even if it didn't have the intended effects, but it wasn't remotely unpleasant taste-wise this way.
I've used the Sutab pills and they were great. They are like a large multivitamin. The number of them is a little annoying (12 taken over about 30 minutes the night before, and another 12 over 30 minutes the next morning).
I had my first one recently and it wasn't really a big deal. I had heard from a few people how horrible the prep was and it really wasn't.
It is definitely worth it if you are past 45.
Miralax + a cold 2 liter bottle of (green) Mountain Dew, FTW!
I find the carbonation masks most of the odd mouth-feel of the solution.
And, it's the only occasion on which I let myself indulge in that stuff :)
Theranos definitely made us cautious but not every new tech needs to be Theranos 2.0. Microfluidics is legit and widely used, sometimes skepticism just means asking the right questions not shutting every door.
In this case i imagine skepticism just means buying some devices and getting an independent lab to run a blind test.
I think Elizabeth Holmes was excited about the right stuff, but she wasn't well enough studied in the science to take it beyond the wouldn't-it-be-neat, sci-fi writing phase, and relied on "fake it till you make it" to compensate for the fact that her reach far exceeded her grasp.
How would any company get around the fact that blood is not homogeneous and if you take only a small amount you aren’t getting a representative sample of the person’s blood so you have a random shot of detecting whatever markers you are looking for?
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Anecdata re: colon cancer, colonoscopy, etc.
2023 https://news.ycombinator.com/item?id=38055711 Are colonoscopies worth it?
2022 https://news.ycombinator.com/item?id=33147680 Effect of Colonoscopy Screening on Risks of Colorectal Cancer and Related Death
“Colorectal cancer is the second-most deadly cancer, killing over 1 million people per year around the world”
That’s 1 million people every year who don’t need to die because colonoscopies are extremely effective at catching early cancer.
In my case, twice. In my mid to late 20’s, and again a few years later when some really early stuff cropped up again.
Get your butts probed. Don’t know what else I could say really.
You are, charitably, ignorant wrt colorectal cancer diagnostics, treatment, and quality of life.
I had precancerous polyps found and removed 7 years ago thanks to a colonoscopy before they caused any problems. I'd most likely be dead right now if not for that procedure.
Awesome! Tissue characterization has come so far so fast and saved so many lives.
> You are, charitably, ignorant wrt colorectal cancer diagnostics, treatment, and quality of life
Just do it, especially if someone in your family had related issues. My mom did it just because, without any symptoms, and they removed around 9 cancerous polyps (in three different colonoscopies, it ended up being a complex case). Accordimg to the doctor she would have been dead 3-6 months later if they didn't have discovered those unbroken polyps on time.
Yes! This. Also get a proper genomic sequencing.
More and more, we're finding colorectal has very strong genetic correlations.
It's not as strong as Huntington's or BRCA, but akin to carpel-tunnel with repetitive hand motions or melanoma with UV exposure, a diet that's "fine" for most, turns out to be a "killer" for a minority.
Strange, considering I got a colonoscopy this summer and found out I had stage 3 colon cancer. Finishing chemo this week.
What don’t you think I understand?
What are the false positive / false negative rates?
In the full text, they did not appear to study the false positive and false negative rates. Their references to "sensitivity" were referring to the fact that they could detect even very small concentrations of the biomarker.
This is reasonable for this kind of study. I would expect a false negative / false positive rates in a study on the commercial device.
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???
Microfluidic chemistry is a mainstream thing. It's used for all kinds of processes, even in large-scale drug manufacturing to replace batch processes.
I did not imply this.
I believe this needs to be tested by other parties, results checked, etc. Like science.
Because claims like this ("diagnose," "small drops," "quick") were made before, people ended up in jail for the tactics used trying to protect the lies when they couldn't make it work.
Sure same as any medical device.
But siezing on the word "microfluidics" because theranos used it, makes about as much sense as seizing on the word "chemistry" and saying theranos also claimed to use chemistry.
Sure, but they're not claiming to analyze everything. Cancer marker detection is an active field, and it often involves checking for the levels of several proteins/RNA fragments.
What they did, they found a material that allows them to microfluidize the processes.
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Microfluidics have been widely used since the 80s, this is like saying a company is a scam just because their sales pitch includes the phrase machine learning.
Actually the whole history of AI have experienced several hype cycles, with huge and expensive failed projects:
This is not really an actually, it's widely and well known. It's also specifically why I said machine learning, not artificial intelligence, the two are not the same thing.
Microfluidics were also key to creating the first line of COVID vaccines. They were also why it was hard to scale up production—turns out machines than can perform microfluidic chemistry aren’t mass produced and take time to make.
>turns out machines than can perform microfluidic chemistry aren’t mass produced and take time to make.
Can you provide a link to more information about this? I was under the (probably mistaken) assumption that microfluidics were using semiconductor-based lithography processes, and we've figured out how to scale the heck out of that.
I can’t find the original article, but Derek Lowe (famously of the Things I Won’t Work With column about exciting chemistry) published a series of articles on the topic around 2021 - 2022.
I did find an interview with Derek Lowe where they talk a bit on the topic, it I haven’t listened through all of it to see if they discuss microfluidics: https://www.earwolf.com/episode/where-oh-where-is-the-covid-...
EDIT: found it! Here’s the write up where Derek Lowe discusses microfluidics devices that ended up being the bottleneck to producing the original COVID vaccines: https://www.science.org/content/blog-post/myths-vaccine-manu...
From the article (there’s more than this):
Ah, but now we get back to Step Four. As Neubert says, "Welcome to the bottleneck!" Turning a mixture of mRNA and a set of lipids into a well-defined mix of solid nanoparticles with consistent mRNA encapsulation, well, that's the hard part. Moderna appears to be doing this step in-house, although details are scarce, and Pfizer/BioNTech seems to be doing this in Kalamazoo, MI and probably in Europe as well. Everyone is almost certainly having to use some sort of specially-built microfluidics device to get this to happen - I would be extremely surprised to find that it would be feasible without such technology. Microfluidics (a hot area of research for some years now) involves liquid flow through very small channels, allowing for precise mixing and timing on a very small scale. Liquids behave quite differently on that scale than they do when you pour them out of drums or pump them into reactors (which is what we're used to in more traditional drug manufacturing). That's the whole idea. My own guess as to what such a Vaccine Machine involves is a large number of very small reaction chambers, running in parallel, that have equally small and very precisely controlled flows of the mRNA and the various lipid components heading into them. You will have to control the flow rates, the concentrations, the temperature, and who knows what else, and you can be sure that the channel sizes and the size and shape of the mixing chambers are critical as well.