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that’s to be expected, after we do the adequate screening for one older population and mitigate many of the advanced versions of that, then the previously edge case becomes more prevalent amongst all cases

there is still a limited resource for the screening at this point, so that’s a friction to expanding screening



It's not just a question of scaling up the screening effort. Doctors are also concerned with potential harms caused by false positives.


What false positive would come out of a colonoscopy? You are visually looking for masses, and removing suspect polyps that are sent in for evaluation. The major potential harm of a colonoscopy is a bowel perforation. Serious complications occur roughly 0.3% of the time.


> Serious complications occur roughly 0.3% of the time.

https://www.cancer.org/cancer/types/colon-rectal-cancer/abou..., “the lifetime risk of developing colorectal cancer is about 1 in 24 for men and 1 in 26 for women.”

So, it’s a 4% lifetime risk versus a 0.3% per colonoscopy risk. The outcomes for the two risks also are different, but I would think that for many healthy people (e.g. those under 40 years old), the risk of doing such a check are greater than that of not taking it.

Reading https://en.wikipedia.org/wiki/Colorectal_cancer#Screening, that’s one of the reasons frequent colonoscopies aren’t advised.


As you said, the outcomes are wildly different. A 0.3% risk of colonoscopy complications vs missing out on catching a mass when it's relatively easy to treat.




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