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A new study finds that compared to people born around 1950, when colorectal cancer risk was lowest, those born in 1990 have double the risk of colon cancer and quadruple the risk of rectal cancer.
The study is led by American Cancer Society scientists and appears in the Journal of the National Cancer Institute. It finds colorectal cancer (CRC) incidence rates are rising in young and middle-aged adults, including people in their early 50s, with rectal cancer rates increasing particularly fast. As a result, three in ten rectal cancer diagnoses are now in patients younger than age 55.
To get a better understanding, investigators led by Rebecca Siegel, MPH of the American Cancer Society used "age-period-cohort modeling," a quantitative tool designed to disentangle factors that influence all ages, such as changes in medical practice, from factors that vary by generation, typically due to changes in behavior. They conducted a retrospective study of all patients 20 years and older diagnosed with invasive CRC from 1974 through 2013 in the nine oldest Surveillance, Epidemiology, and End Results (SEER) program registries. There were 490,305 cases included in the analysis.
The study found that after decreasing since 1974, colon cancer incidence rates increased by 1% to 2% per year from the mid-1980s through 2013 in adults ages 20 to 39. In adults 40 to 54, rates increased by 0.5% to 1% per year from the mid-1990s through 2013.
Also at The New York Times
Study: Colorectal cancer incidence patterns in the United States, 1974-2013; J Natl Cancer Inst (2017) 109(8): DOI: 10.1093/jnci/djw322
(Score: 1, Informative) by Anonymous Coward on Wednesday March 01 2017, @08:03PM (7 children)
> General anesthesia has you in a semi-sedated state ahead of the procedure, then for the procedure and some recovery, and after that you're still kind of loopy so they have you get someone to drive/Lyft you back. After that, you're still not all there, so you may not be able to go to work.
This is incorrect. General anesthesia involves a level of anesthesia high enough to affect breathing so a breathing tube is placed, after paralytics are given, and breathing is controlled by the anesthesiologist. Most colonoscopies are done under conscious sedation, which you are referring to. The patient can still control his/her own breathing as well as respond but do not remember too much of the procedure. Colonoscopies are typically done under general anesthesia if there is a high enough medical risk that conscious sedation would have to be converted to general anesthesia during the procedure, but that is not decided by the patient.
(Score: 4, Interesting) by edIII on Wednesday March 01 2017, @09:41PM (2 children)
You're talking out of your butt :)
It IS the patient's decision, and in my case, the deciding factors were FINANCIAL. It was IN the operating room that I met my anesthesiologist and he gave me two options. Sedation, but I would be somewhat awake and could remember things or GA in which I would remember nothing. The latter was $350 more dollars.
I looked at his face, then looked at the wall with Borg-like conduits scheduled up my butthole, then back at this face, then back at the rack, then back at his face, back at the rack....
Who would want to remember that?! Shit, Doc, you just sold me your services. Persuasive man you are...
Technically, lunchtime is at any moment. It's just a wave function.
(Score: 0) by Anonymous Coward on Thursday March 02 2017, @04:33AM (1 child)
If you were in the operating room with an actual anesthesiologist present for the procedure, that means there was enough concern that something could go wrong. Most routine colonoscopies do not have an anesthesiologist present. During an average "non-complicated" colonoscopy (performed in a GI suite, not an OR) a nurse pushes the feel-good drugs, but the GI doc doing the procedure is in charge of the anesthesia. In that case a patient can request GA, but unless there's a real medical reason, severe anxiety, history of difficult procedures in the past it won't be considered. Although, anesthesiologists have pretty much perfected general anesthesia, there are still risks. I have seen patients go into cardiac arrest during induction of general anesthesia (during non-complicated procedures). FYI I'm an internist and routinely care for patients inside and outside the hospital who require the simple colorectal cancer screening colonoscopy every 10 years, or someone in the hospital who has lower GI bleeding.
(Score: 1) by anubi on Thursday March 02 2017, @10:33AM
I know when they rammed me, I got to retching in some sort of gag state.
They had to put me down pretty fast before I tore myself up with my guts full of their stuff.
There was nothing much I could do about it. Some sort of gag reflex.
"Prove all things; hold fast that which is good." [KJV: I Thessalonians 5:21]
(Score: 2) by krishnoid on Wednesday March 01 2017, @09:52PM (3 children)
My mistake -- it was "conscious sedation" or "twilight anesthesia", not "general anesthesia".
(Score: 1) by purple_cobra on Wednesday March 01 2017, @10:41PM (2 children)
Yeah, that's the more likely option. GA isn't likely unless the surgeon wants to do an examination under anaesthetic (EUA), which generally involves a minor procedure (dilatation or multiple polypectomy are the classic ones). Sedation is for the nervous patient and knowing a reasonable amount about this procedure - plus having had an LA-only gastroscopy in the past - I'd be asking for sedation unless there was a damn good reason why I shouldn't have it. You should not be alone for 24 hours after sedation and should not make any life-changing decisions or sign any documents, but check with your anaesthetist beforehand.
One of our patients has to come back every six weeks or so to have his anus dilated back to a normal level as some quirk of his biology means he's otherwise in serious pain, at risk of doing himself damage, etc, just from a normal bodily function. Knowing this kind of thing exists means I can't get too worked-up over my own genetic weirdness - at least I can still perform this basic function without risking injury.
Something you might not know about having a colonoscopy is that your bowel is inflated with air while the examination is happening, so you will have some prize-winning farts during and after the procedure. You'll also have to take a bowel cleanser beforehand, basically a laxative with a turbo. Thankfully I've been spared this so far, but we tell patients not to be more than a few seconds from a toilet if they want to be safe!
(usual caveat: I am not a doctor, so please consult one if this comment is any way relevant to you).
(Score: 1) by anubi on Thursday March 02 2017, @10:41AM (1 child)
The last time I did this, I was told to take a massive dose of sodium phosphate. "Phospho-soda".
You ain't kidding. That stuff gave me the squirts big-time.
Sure got a big mess out of that little bottle.
It seemed to take forever and a day to get the intestinal flora and fauna back after that go-around with the silver stallion.
This is not something I had much pleasure in at all.
"Prove all things; hold fast that which is good." [KJV: I Thessalonians 5:21]
(Score: 1) by purple_cobra on Wednesday March 08 2017, @05:51PM
In the UK - at least in the place I work - we use either Fleet (your Phospho-soda), Picolax or some combination thereof. I read the instructions/warnings on a bottle of Fleet and they weren't joking with that name; you'd need to be fleet indeed to get to the required place in time after taking that stuff! All I can really say is that you won't be prescribed this kind of medication for anything other than a damn good reason.