According to the American College of Gastroenterologists (ACG), adenoma detection rate (ADR) is “the measurement that best reflects how carefully colonoscopy is performed.“ Defined as the percentage of patients age 50 and older undergoing screening colonoscopy who have one or more precancerous polyps detected, ADR is calculated by dividing the number of procedures in which one or more adenomas is detected by the total number of procedures. An endoscopist’s ADR should be at least 25% for men and 15% for women.
The human gut microbiome comprises all of the bacteria in in the human intestine, which amounts to over 100 billion bacteria. This outnumbers the cells in our bodies 10 to 1. Although probiotic products touting gut health are currently flooding the marketplace (ranging from dietary supplements to cake mixes), there is no consensus on what a healthy human microbiome looks like, and none of these products have been approved by the FDA to treat or prevent specific diseases. While most agree that it is essential to human health, facts about the microbiome and how it functions in the body are still under investigation.
There is no doubt that the partial government shutdown, the longest in US history, is having a detrimental effect on the 800,000 Federal government employees and their families. In response to the crisis, some furloughed workers have gone to extreme measures; thousands have created GoFundMe pages to help pay for necessities like food, childcare, and medicine.
Put yourself in their shoes. Now imagine that you have cancer.
Lynch syndrome is one of the most common hereditary cancer syndromes and the most common cause of inherited colorectal cancer (CRC) in the Unites States. An estimated one out of every 300 people could be a carrier. Given these statistics, it would seem that if testing is readily available (it is) and affordable (it is), it should be routinely performed (it isn’t).
The safety and comfort of patients undergoing colonoscopy is of paramount importance to hospitals, providers, and of course, the patients themselves. But what about the physicians performing the procedure? It might be news to those outside the field, but gastroenterologists are commonly injured on the job. A review of current literature found that musculoskeletal complaints are extremely common among GIs; the incidence of pain and injuries ranges from 29% up to 89%. Another study indicated that 45% of endoscopists undergo physical therapy to combat pain, 26.8% get steroid injections, and 13.3% require surgery.
Observational studies indicate that colonoscopy lowers colorectal cancer (CRC) rates and mortality in the general population. In support of these findings, a large-case control study showed that the procedure can significantly reduce the incidence of CRC and CRC-related mortality. However, colonoscopy may not be optimally effective for right-sided lesions. This might be due, in large part, to sessile serrated adenomas (SSAs).
If Colonoscopy Is the Gold Standard, Why Is Compliance So Low?
In 2018, 50,630 people in the United States will die of colorectal cancer, according to the American Cancer Society. It is the third leading cause of cancer-related deaths in men and women in this country.
Does FIT Measure up to Colonoscopy?
How do fecal immunochemical tests (FITs) stack up to colonoscopy, the gold standard for colon cancer screening? Admittedly, FIT might sound pretty good—no special diet, no colonoscopy prep, no hospital gown. But everything that shines is not gold.