Should I Agree to a Colonoscopy After a Negative FOBT?

Advice on Colonoscopy After Negative FOBT


I'm a male, age 46, in excellent health. A recent blood test revealed that I was slightly anemic. My doctor ordered a fecal occult test (FOBT), which came back negative. Still, my doctor recommends a colonoscopy. Until two years ago, I donated blood regularly, and at my last donation, they said I just barely qualified because of low iron in my blood, undoubtedly from frequent blood donations. I haven't donated since. I eat very little red meat (I'm not a vegetarian, but almost.)

Anyway, I'm reluctant to do the colonoscopy partly for financial reasons (I have a $2,500 deductible and would therefore have to pay the whole thing myself), and partly because I don't know why it would be necessary, since my FOBT came back negative.

I'm not asking for medical advice for me, but for general information. For the average person, does it make sense to do a colonoscopy if you're slightly anemic but your FOBT is negative?

Many thanks for any advice you can provide.



I can think of a couple of reasons why your doctor may want you to have a colonoscopy even though your FOBT was negative. One is that FOBTs aren't 100% accurate. You may already be aware that they sometimes give false positives (i.e., they say there's blood in your stool even though there isn't). But did you know FOBTs sometimes give false negatives, too? It's possible that even though the FOBT didn't detect any blood in your stool, blood is there.

There has to be some reason why you're anemic. Maybe your doctor strongly suspects that the answer is somewhere in your colon, and the only way to find out definitively is to take a look. An actual look, with a camera.

Another thing you might want to keep in mind is that most people are supposed to get screened for colorectal cancer starting at age 50. Since you're 46, if you plan to follow national colon cancer screening guidelines, you'll be paying for some type of colorectal cancer screening in the next four years, anyway.

Maybe your doctor feels that starting a little early would be a good idea in your case.

The American Cancer Society recommends receiving a colonoscopy every 10 years if no abnormalities are found. So, if you decide to get one now, you might not need another one until you're 56. Perhaps your doctor wants to err on the side of caution and get you off to an early start.



This is all speculation, of course, since I'm not a medical professional. Really, the best advice I can give you is to ask your doctor why he/she feels it's necessary to do a colonoscopy even though your FOBT was negative. If you don't receive a satisfactory answer, get a second opinion.

Hope that helps.

Please remember that I am not a medical professional. I offer my input as a neighbor, a friend, sitting at the kitchen table talking about what's on your mind and trying to help if I can. This is not medical advice. Please don't consider it medical advice or pass it on to others as medical advice. Thanks.

Sources:

  1. American Cancer Society Guidelines for the Early Detection of Cancer. American Cancer Society. 28 Feb. 2006. 24 Jun. 2006 [http://www.cancer.org/docroot/PED/content/PED_2_3X_ACS_Cancer_Detection_Guidelines_36.asp].
  2. Healthcare Center: Fecal Occult Blood Test (FOBT). 24 Jun. 2006.
  3. Medical Encyclopedia: Fecal Occult Blood Test (FOBT). Medline Plus. 10 Nov. 2004. 24 Jun. 2006 [http://www.nlm.nih.gov/medlineplus/ency/article/007008.htm].


    I'm a male, age 46, in excellent health. A recent blood test revealed that I was slightly anemic. My doctor ordered a fecal occult test (FOBT), which came back negative. Still, my doctor recommends a colonoscopy. Until two years ago, I donated blood regularly, and at my last donation, they said I just barely qualified because of low iron in my blood, undoubtedly from frequent blood donations. I haven't donated since. I eat very little red meat (I'm not a vegetarian, but almost.)

    Anyway, I'm reluctant to do the colonoscopy partly for financial reasons (I have a $2,500 deductible and would therefore have to pay the whole thing myself), and partly because I don't know why it would be necessary, since my FOBT came back negative.

    I'm not asking for medical advice for me, but for general information. For the average person, does it make sense to do a colonoscopy if you're slightly anemic but your FOBT is negative?

    Many thanks for any advice you can provide.


    I can think of a couple of reasons why your doctor may want you to have a colonoscopy even though your FOBT was negative. One is that FOBTs aren't 100% accurate. You may already be aware that they sometimes give false positives (i.e., they say there's blood in your stool even though there isn't). But did you know FOBTs sometimes give false negatives, too? It's possible that even though the FOBT didn't detect any blood in your stool, blood is there.

    There has to be some reason why you're anemic. Maybe your doctor strongly suspects that the answer is somewhere in your colon, and the only way to find out definitively is to take a look. An actual look, with a camera.

    Another thing you might want to keep in mind is that most people are supposed to get screened for colorectal cancer starting at age 50. Since you're 46, if you plan to follow national colon cancer screening guidelines, you'll be paying for some type of colorectal cancer screening in the next four years, anyway. Maybe your doctor feels that starting a little early would be a good idea in your case.

    The American Cancer Society recommends receiving a colonoscopy every 10 years if no abnormalities are found. So, if you decide to get one now, you might not need another one until you're 56. Perhaps your doctor wants to err on the side of caution and get you off to an early start.

    This is all speculation, of course, since I'm not a medical professional. Really, the best advice I can give you is to ask your doctor why he/she feels it's necessary to do a colonoscopy even though your FOBT was negative. If you don't receive a satisfactory answer, get a second opinion.

    Hope that helps.

    Please remember that I am not a medical professional. I offer my input as a neighbor, a friend, sitting at the kitchen table talking about what's on your mind and trying to help if I can. This is not medical advice. Please don't consider it medical advice or pass it on to others as medical advice. Thanks.

    Sources:

    1. American Cancer Society Guidelines for the Early Detection of Cancer. American Cancer Society. 28 Feb. 2006. 24 Jun. 2006 [http://www.cancer.org/docroot/PED/content/PED_2_3X_ACS_Cancer_Detection_Guidelines_36.asp].
    2. Healthcare Center: Fecal Occult Blood Test (FOBT). 24 Jun. 2006.
    3. Medical Encyclopedia: Fecal Occult Blood Test (FOBT). Medline Plus. 10 Nov. 2004. 24 Jun. 2006 [http://www.nlm.nih.gov/medlineplus/ency/article/007008.htm].

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