If you tell your doctor that a parent had polyps removed (say, recently), that will give you your best chance of getting one. Most likely, if you're in an even remotely progressive area, your doc wants you to have one, but their hands are tied by the insurance company. Afaik you dont have to provide any proof of your claim re parental polyps.

> but their hands are tied by the insurance company.

Doctors' ability to prescribe or refer is never restricted by an insurance company. If they think a patient should get whatever healthcare, they are free to say it.

In CA, my doctor can refer me to get a Cologuard. But it's private pay, and they want payment up front since isurance companies don't restrict doctor's ability, only reimbursement.

So they may not be willing (even though they are able) perform procedure/test if they aren't confident they'll get paid.

You are just ignoring their intended meaning. Boring.

Is the intended meaning that health insurance should pay for anything and everything? Even systems where the government pays directly like the UK have parameters under which the government will pay for a procedure or medicine.

Not at all. Patients are free to pay out of pocket for procedures not covered by insurance. An extra colonoscopy (one not classified as medically necessary), while expensive, is within the financial means of most middle-class adults.

The average American says US healthcare spending, which is 3x to 20x that of other OECD countries on a per capita basis, is way too high.

The average American also thinks they should be provided testing and procedures that their insurance deems medically unnecessary.

Try to reconcile these two beliefs. (Hint: It's impossible)

Maybe there's a bunch of inflated profit margins and people getting filthy rich off a poorly regulated market.

Lie about family history, but even colonoscopies are not perfect; I just had somebody in my family die of CRC because...

- They had symptoms and wanted a screening, but their PCP repeatedly denied them a referral for like a year because they were "too young".

- They lied about family history after symptoms got worse and got their referral.

- They got the colonoscopy which came back clean, and then symptoms continued to get worse.

- Finally their doctor gave them a referral for an MRI.

Results were stage 4 CRC. The doctor performing the colonoscopy missed the tumor, which was tucked into the sigmoid (the bend in your colon), where he didn't properly inflate because he wasn't taking it very seriously. It had a thumb-tip sized protrusion inside the colon but had gotten huge on the opposite side of the colon wall. They fought it for 8 years after the diagnosis and over 100 rounds of chemo (!!!), were about to get a new procedure at Yale, in which the doctor told them to think of it in terms of "this really may be a complete cure", but it was canceled because of the Big Beautiful Bill.

If you have symptoms (even if you don't), don't let some fuckass Nurse Practitioner tell you no. They don't know shit and they let their egos get in the way when they have to deal with moderately informed patients advocating for themselves. This was preventable and tge medicap system failed them because both the PCP and the doctor performing the colonoscopy were not paying attention to what they were being presented with and saw only their own expectations.

Also...apparently doctors wanted to lower the screening age to like 35, but insurance companies fought it, so it's at 45.

IANAL, just a CRC survivor and one who had my PCP miss my diagnosis a year before I started treatment. You may have a pretty good malpractice claim.

I'm a little removed from the situation, (not my nuclear family) but I believe the statute is up. It's too difficult to litigate in, say, the first two years of your stage 4 diagnosis before the law won't allow a suit.

>Also...apparently doctors wanted to lower the screening age to like 35, but insurance companies fought it, so it's at 45.

On this website, it is frequently opined that because health insurers have a legal minimum medical loss ratio, that health insurers prefer inflated costs so that their medical losses are higher, which means their premiums can be higher, which means their revenue is higher, which means their profit is higher.

I would have thought health insurers would support a lower screening age, especially since it would inflate costs for all insurers so everyone's cut of the now bigger pie gets bigger.

while it sucks, paying for it out of pocket is probably cheaper if you can't get it covered. In the long run, $1500 as a bridge until your 40s feels cheaper than stage 4 cancer.

$1500? That sounds optimistic. I'm getting an upper endoscopy tomorrow and they've already told me it will be $4K. The equipment is similar, I expect colonoscopy is not cheaper.

> even though it’s a relatively benign procedure.

Not completely. Every once in a while they accidentally puncture the intestine with the probes and that becomes a significant medial problem. It doesn't happen often, but that is still a risk that doctors need to consider. If you are over 50 getting one every 10 years is a good idea, and there is some consideration if younger might be worth it. However so few people get colon cancer under 40 that it isn't worth the risks for most - but if there are other signs of a problem (either family history or symptoms) that changes things and it may be worth it.

I was diagnosed at 35 seven years ago with no history. Getting a colonoscopy never crossed my mind, much less being suggested by my general practitioner.

The trigger for me was blood in my stool. It was the slightest amount but I pursued it because that didn’t seem right. Turns out I had hemorrhoids which brought up something I feel hits others - I was embarrassed.

Fortunately the doctor that performed a banding procedure pushed me to get a colonoscopy purely out of being through and seeing the number of incidences increase at my age range.

I often wonder how much the embarrassment factor comes into play here.

Was it a consistent blood in stools or just a one time thing? I've had what I think that is once or twice and then take the approach to just see if it recoccurs a second time before going to a doctor, not sure if that's the correct approach or if a single instance should be alarming enough.

My bloody stool started slow and took some time off but came back and I had a large polyp. Watch this very closely, but don't panic.

For me it was small amount consistently. But I cannot stress enough that it was the diagnosis of hemorrhoids coupled with a very proactive doctor that led to me being diagnosed with cancer. It was a lucky circumstance that it was staged early because the additionally suggested screening was not standard protocol for my age.

If you have any abnormalities in your bowel movements (blood, ribboning, etc.) and you have the ability to get it checked then it could offer peace of mind. And yes, there are small chances of intestinal perforations with a colonoscopy.

Blood in the stool, at age 41. Benign but a VERY large polyp so I have a followup soon. If you have an instinct to get tested, especially if you have any evidence, do it. My doc fought me to NOT get tested but I persisted. The embarrassment factor is a thing, but we have to get over it!

For a screening procedure recommended as a mass conducted preventative measure in otherwise healthy people, harms must be regulated to a better standard than "doesn't happen often". The study that I read of was about serious issue occuring something like one in 120 procedures. It was done at Kaiser. Next time you're enjoying a sausage, take a moment to look at the sausage skins. If I understand correctly, our intestinal walls are quite thin, and even the colon vulnerable.

> I’m in my early 30s and am starting to think about getting a screening.

This is a pretty stupid thing to do unless you've had some sort of symptom or family history. Your protection from illness due to screening is statistical, and jumping out of the calculated recommendation just makes it more likely to hurt you (false positives, false negatives, injuries from the procedure) than to benefit you.

Desperately trying to fabricate a reason is just intentionally trying to hurt yourself.

I'm not against colonoscopies (is anyone?) and I personally had my first one early because of an odd pain. Turned out to be unrelated.

edit: the neurotic desperation for disease screening that I see in a lot of people bothers me a lot because it's this odd fetishization of medical science combined with the active subversion of it. For me it's a weird insistence that all tests are good but that the math behind them is not.

From a 'public health' perspective, it makes perfect sense to limit the frequency of screening procedures by age and other broad risk-factors, but that doesn't help at the individual level if you fall on the unlucky side of those statistics.

Most cancers are still very much lethal once they progress to a certain point, and the best treatment we know of is early detection. Many of the cancer screens are harmless or don't add significant risk of death, so it really comes down to money and medical resource availability (also solved with money.)

I don't see much difference in someone paying out-of-pocket for a full-body MRI/colonoscopy vs. them spending way above average on any other item that slightly reduces the risk of dying (how many smoke alarms and fire extinguishers does your home have?)

> that doesn't help at the individual level if you fall on the unlucky side of those statistics

As GP stated, there's the other unlucky side of the statistics with false positives.

I've decided to invest $2000/year and get an MRI scan every year. My first one, the baseline, showed nothing remarkable, thank God. I'm scheduled for my second one in a few weeks, I want to be able to catch anything weird very early on. I think it's worth it despite what all the know-it-alls say.

Can an MRI catch it? It would be ideal if the cost of MRIs came down so everyone could access it. Where's Moore's law for ~tricoders~ MRIs?

Would an MRI detect polyps?