Paul's blog

This post is related to my two previous posts.
Recently I was listening to some details about a certain type of ‘minimally invasive’ surgery, when at some point the risks were brought up.
It was explained that this procedure was relatively safe, as it had a risk, expressed in mortality rate, comparable to that of a colonoscopy.
That sounded very reassuring, since a colonoscopy doesn’t involve incisions and messing with vital organs.
Then I saw the actual numbers and sure enough, they were fairly close.

But I was shocked nevertheless.

In 2004 I had a colonoscopy, based on my primary care physician’s recommendation to ANYONE who turns 50, to have one. Just as a precaution.
Since they did remove some polyps, it was recommened to have another one in 2006. I’m overdue for that one, and I really should get one scheduled.

Or SHOULD I?

I’m still shocked by the mortality rate of a colonoscopy. It was given as around 1 in 2000.
It is recommended that by the time you turn 50, you should get a colonoscopy, and then one every 5 years after that (or more often when they find something).
There are about 50 million people over the age of 50 in the US. If they would all follow the recommendation, each year 10 million people will have a colonoscopy! With the above mentioned mortality rate, 5,000 people WILL die each year by simply having a colonoscopy.
This scares me a lot.
I had no idea that such a procedure would kill one out of every 2000 patients.

The past few days I have been thinking a lot about this number.
And now I do of course realize that there’s another side of this coin. Something that poker players may recognize as a pot odds calculation: what is the cost of NOT having one. What are the odds that I DO develop undetected colon cancer.
When I wrote my ‘Odds’ post, I was still heavily leaning towards not going in for my second one.

But now, considering that this is widely recommended (so you think that someone has done the proper statistical analysis of the odds involved^1.) PLUS the fact that I am more at risk due to the removed polyps .. maybe I SHOULD get another one.

I’m not asking my readers to make this decision for me, but I would appreciate their thoughts on this mortality rate^2..

^1.Here I appear to follow one of my commenter’s remarks, basically saying “If the authorities say it’s safe, I don’t care too much about the numbers”. But there is a difference I think.
^2.I restricted myself to mortality, there are also various other, rather nasty, risks (like colon perforation) that require immediate and complicated surgery)

7 Responses to “Colonoscopies and pot odds”