I'm always recommending a screening colonoscopy to my patients 'of age,' after all,
I had one, therefore, so can they. Here's the top two excuses (after 'I'm a chicken' and 'I'm embarrassed') that people give me for not undergoing this important screening test, and here's what I have to say to them:
1)
No one in my family has colon cancer.While having a first degree relative (parent or sibling) with a history of colorectal cancer (CRC) increases risk 2-fold, 80% of persons who get CRC have no such family history.
2)
I eat a high fiber diet.Boston doctors undertook a prospective study of nearly 89,000 women ages 34-59 in 1980.(1) They found no association between dietary fiber intake and the risk of CRC during 16 years of follow-up.
One might raise the question, as did Dr. Neil Raven(2), as to what really constitutes a high fiber diet. He responded to the above study in a letter to the editor wondering if the flaw in the study's design might not be that Boston women who say they eat high fiber aren't really as fiber-filled as they think. He cited information from Dr. Denis Burkitt, a physician who spent time in West Africa studying lifestyle and disease. Per Dr. Raven:
Burkitt began his lecture with a slide showing a stool of a typical Western, "civilized" person, a sausage-shaped thing, familiar to most of us, in a toilet bowl. His next slide was of a stool of a typical rural West African, which looked like a flat cow pie. Burkitt postulated that the West African's stool moved more quickly through the colon, giving carcinogens contained on its surface less time to be in contact with the mucosa — thus less time to induce carcinogenesis.
During the question-and-answer period, many questions from the audience concerned how one determined whether or not a diet was high in fiber in the sense Burkitt meant. Burkitt shook his head at all the salads, cereals, and breads offered as sources of fiber. He showed a slide of the staple cereal eaten by West Africans, which looked, in its wooden bowl, not too different from the stool that came out the other end. The only thing the study by Fuchs et al. proves is what anyone who heard Burkitt's lecture already knew: the American public has been sold a sugar-coated misconception._____
(1)Fuchs, CS et al. Dietary Fiber and the Risk of Colorectal Cancer and Adenoma in Women.
NEJMVolume 340:169-176 January 21, 1999 Number 3.
(2)Raven, ND. Dietary Fiber and Colorectal Cancer.
NEJMVolume 340:1924-1926 June 17, 1999 Number 24.
1)No one in my family has colon cancer.While having a first degree relative (parent or sibling) with a history of colorectal cancer (CRC) increases risk 2-fold, 80% of persons who get CRC have no such family history.
2)I eat a high fiber diet.Boston doctors undertook a prospective study of nearly 89,000 women ages 34-59 in 1980.(1) They found no association between dietary fiber intake and the risk of CRC during 16 years of follow-up.
One might raise the question, as did Dr. Neil Raven(2), as to what really constitutes a high fiber diet. He responded to the above study in a letter to the editor wondering if the flaw in the study's design might not be that Boston women who say they eat high fiber aren't really as fiber-filled as they think. He cited information from Dr. Denis Burkitt, a physician who spent time in West Africa studying lifestyle and disease. Per Dr. Raven:
Burkitt began his lecture with a slide showing a stool of a typical Western, "civilized" person, a sausage-shaped thing, familiar to most of us, in a toilet bowl. His next slide was of a stool of a typical rural West African, which looked like a flat cow pie. Burkitt postulated that the West African's stool moved more quickly through the colon, giving carcinogens contained on its surface less time to be in contact with the mucosa — thus less time to induce carcinogenesis.
During the question-and-answer period, many questions from the audience concerned how one determined whether or not a diet was high in fiber in the sense Burkitt meant. Burkitt shook his head at all the salads, cereals, and breads offered as sources of fiber. He showed a slide of the staple cereal eaten by West Africans, which looked, in its wooden bowl, not too different from the stool that came out the other end. The only thing the study by Fuchs et al. proves is what anyone who heard Burkitt's lecture already knew: the American public has been sold a sugar-coated misconception.
_____
(1)Fuchs, CS et al. Dietary Fiber and the Risk of Colorectal Cancer and Adenoma in Women.NEJMVolume 340:169-176 January 21, 1999 Number 3.
(2)Raven, ND. Dietary Fiber and Colorectal Cancer.NEJMVolume 340:1924-1926 June 17, 1999 Number 24.