The rest of the world knows a lot more than we do in the U.S. about safer screening and prevention of colon cancer. In fact, in the U.S., the government-industrial-medical complex purposefully keeps us in the dark about many safe and effective alternatives to colonoscopy. In other countries around the world, colonoscopies are barely used at all anymore. But in the U.S., colonoscopy is too big of a cash cow for GI specialists and anesthesiologists to let it go easily.
Case in point?
In 2014, the FDA approved the use of an easy, ingestible camera pill for colon cancer screening as an alternative to colonoscopy. Eighty countries around the world approved the “pill cam” for use before the U.S., including Australia, Canada, Japan, and many European countries.
But the FDA strictly limits use of the camera pill, so very few patients can benefit from it. Plus, GI doctors remain reluctant to recommend it in the U.S. (It must be the only example in modern history where mainstream doctors don’t want patients to swallow more pills!)
The new camera pill can take pictures of different parts of the intestines, including the colon (or large intestine). And it confers superior, clear images for examining the small intestines from the inside. Plus, the camera pill can see 25 feet of the duodenum and small intestine. By contrast, endoscopes (the type of medical device used to perform colonoscopies) can only show the doctor about two to three feet. Yet, despite their limited “scope,” endoscopes are now notorious for spreading superbugs and even killing patients around the country.
Superior, safe technology fails to garner support
Clearly, the camera pill offers many advantages over colonoscopies. The camera is only about the size of a dietary supplement capsule. Patients simply swallow the pill, and it takes multiple photos over a period of eight hours as it passes down through the GI tract.
Plus, the camera pill carries few risks. It doesn’t require sedation or anesthesia.
And the prep is also simpler. For the small intestine, a patient must fast for just 12 hours. (You can conveniently start this fast after dinner the night before the procedure). For the colon, it does require a full 24-hour fast.
The camera pill can identify polyps, cancers, and sources of GI bleeding.
It can also find inflammation and conditions such as inflammatory bowel disease (Crohn’s disease), celiac disease, diverticulitis, and ulcers.
But don’t get too excited yet.
Despite a superior screening technology, the new camera pill faces an uphill battle to gain acceptance among doctors in the U.S.
Yes we have a better tool, but you can’t use it
The FDA only approved the pill cam as a “secondary tool” for GI specialists when colonoscopy fails to give clear images. It is NOT approved as a first-line alternative to colonoscopy.
It’s a bit mind-boggling.
We have another great, safe tool to screen for colon cancer. But we can only use it when colonoscopy, which has many limitations, fails.
Of course, the FDA positions all the alternatives for colon cancer screening as “secondary tools” to colonoscopy. This stance means that safer and less expensive screening approaches won’t ever have even a chance to gain real traction in the U.S. as they do in Europe and elsewhere.
Research shows more frequent screenings that can be done with easier and safer fecal occult blood testing, or flexible sigmoidoscopy, prevent about the same number of deaths as getting a colonoscopy every 10 years. Put another way, the “alternatives” extend life by about the same amount as colonoscopy — which should really be the “bottom line,” so to speak.
Plus, the widely available new test called Cologuard that detects fecal DNA is another great alternative. Evidence shows it’s even more sensitive and accurate than other proven “alternatives.”
Overall, research shows public health outcomes for colon cancer improve with any procedure, as long as the patient is actually willing to accept it and get it done. And, obviously, patients are more likely to have a test done if it is more convenient, and not another medical ordeal.
But instead, we are forced to get dangerous, expensive colonoscopies first…and risk contamination from dirty scopes and ineffective cleaning machines, not to mention all the other complications of torn intestines, lacerated livers, internal bleeding, and even death.
It’s quite a racket.
In my view, doctors should do more to promote the safe, effective alternatives for colonoscopy. So I decided to launch a new citizen initiative called the Safe Colon Cancer Screenings Initiative to urge Congress and the FDA to increase public awareness of these alternatives.
And the first initiative is a petition we intend to send to the U.S. House of Representatives Committee on Oversight and Government Reform. Please consider supporting this important initiative — and adding your name to this petition.
“Pill camera to screen for colon cancer approved in U.S.,” CBC (www.cbc.ca.com) 2/4/2014