Stool examination vs CEA blood test vs colonoscopy

[scubascuba3]

In UK men are offered stool examinations every 2 years from 50 for Colon cancer screening, here in Pattaya I can't see where they do this test, they seem to rely on colonoscopies instead. 

 

Is a CEA test a worthwhile alternative? anybody get it regularly?

[WhiteBuffaloATM]

Had a basic 3k blood test pkg recently at private hospital, which included some kind of stool and urine tests.doctor found nothing from results so no need for his next step of colonocopy which they “ recommend” to drive revenue up from these tests.

[KhunLA]

Get stool & CEA (and the rest of cancer markers) done every year or so, during full health check up.  Colonoscopy every 5 yrs.

[scubascuba3]

13 minutes ago, WhiteBuffaloATM said:

Had a basic 3k blood test pkg recently at private hospital, which included some kind of stool and urine tests.doctor found nothing from results so no need for his next step of colonocopy which they “ recommend” to drive revenue up from these tests.

I just went to a clinic and their "stool examination" is for parasites\bacteria so might be worth checking exactly what tests you had done

[scubascuba3]

44 minutes ago, KhunLA said:

Get stool & CEA (and the rest of cancer markers) done every year or so, during full health check up.  Colonoscopy every 5 yrs.

Clinic in Pattaya is doing these tests in a package, not sure if these are worthwhile

[bbko]

Someone please correct me if I'm wrong, but CEA tests doesn't show the presence of benign polyps. 

[WhiteBuffaloATM]

i had no cancer markers so sufficient for me. no symptoms. plant diet, water, sleep & exercise. 

best lifestyle. never any guarantees.

[KhunLA]

1 hour ago, bbko said:

Someone please correct me if I'm wrong, but CEA tests doesn't show the presence of benign polyps. 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4483931/

https://cancer.ca/en/treatments/tests-and-procedures/carcinoembryonic-antigen-cea

Edited October 29, 2021 by KhunLA

[Pravda]

Btw just found out something today when I had one of those 3k baht test specials. They had a colonoscopy/endoscopy special for 25,000 baht which normally you have to pay out of your own pocket. However the doctor said if he writes up to be admitted which usually means spending a night at the hospital the insurance will fork out the costs.

 

The only thing they require is 3000 baht covid test ????

[Sheryl]

CEA is absolutely not a suitable screening tool and should never be used for that purpose. Not only will it not show presence of polyps, it will nto show many cancers and on the other hand will often be positive in the absence of cancer.

 

" CEA is not recommended for screening or diagnosis of colorectal cancer. Sensitivity
and specificity are both very low as levels are frequently normal in early disease and
may be raised in many benign diseases and most types of adenocarcinoma....

CEA has poor sensitivity for diagnosis of early colorectal cancer, (3%, 25%, 45%,and 56%
in Dukes stage A, B, C and D colorectal cancer respectively, at a cut off of 5 ug/L)
Specificity is also poor, as many benign diseases as well as most types of adenocarcinoma
can give rise to elevated CEA concentrations
Therefore CEA cannot be recommended for a screening test in  unselected individuals
and cannot be used alone for diagnosing or ruling out colorectal cancer."

http://www.nbt.nhs.uk › sites › default › files › G...

 

Stool test for occult blood is better than nothing but nowhere equal to a colonoscopy. Further tests will be necessaery if it is positive, it will often fail to detect polyps, etc.

 

Colonoscopy is still the gold standard for screening for colorectal cancer, and has the huge advantage of not only identifying but allowing for removal of pre-cancerous polyps.

 

[Sheryl]

1 hour ago, scubascuba3 said:

Clinic in Pattaya is doing these tests in a package, not sure if these are worthwhile

 

Except for  PSA, absolutely not worthwhile - none of these tests are suitable for cancer screening. Many false negatives and also positives due to conditions other than cancer. Private hospitals love these tests as they lead to a lot of other, expensive (and often unnecessray) tests.Not a single public health authority in the world recommends AFP, CEA and CA-199 for mass screening.

[ThailandRyan]

1 hour ago, bbko said:

Someone please correct me if I'm wrong, but CEA tests doesn't show the presence of benign polyps. 

yep only a camera gliding up inside the rectum can see them along with hemorrhoid's.  

[scubascuba3]

14 minutes ago, Sheryl said:

CEA is absolutely not a suitable screening tool and should never be used for that purpose. Not only will it not show presence of polyps, it will nto show many cancers and on the other hand will often be positive in the absence of cancer.

 

" CEA is not recommended for screening or diagnosis of colorectal cancer. Sensitivity
and specificity are both very low as levels are frequently normal in early disease and
may be raised in many benign diseases and most types of adenocarcinoma....

CEA has poor sensitivity for diagnosis of early colorectal cancer, (3%, 25%, 45%,and 56%
in Dukes stage A, B, C and D colorectal cancer respectively, at a cut off of 5 ug/L)
Specificity is also poor, as many benign diseases as well as most types of adenocarcinoma
can give rise to elevated CEA concentrations
Therefore CEA cannot be recommended for a screening test in  unselected individuals
and cannot be used alone for diagnosing or ruling out colorectal cancer."

http://www.nbt.nhs.uk › sites › default › files › G...

 

Stool test for occult blood is better than nothing but nowhere equal to a colonoscopy. Further tests will be necessaery if it is positive, it will often fail to detect polyps, etc.

 

Colonoscopy is still the gold standard for screening for colorectal cancer, and has the huge advantage of not only identifying but allowing for removal of pre-cancerous polyps.

 

Very useful I missed the Stool occult blood test which is available at a local clinic, it seems this is the same as a FIT test which is what is used by the UK NHS for bowel cancer screening I mentioned in the OP so it's at least a start

[Sheryl]

18 hours ago, scubascuba3 said:

Very useful I missed the Stool occult blood test which is available at a local clinic, it seems this is the same as a FIT test which is what is used by the UK NHS for bowel cancer screening I mentioned in the OP so it's at least a start

FIT is a newer test nto yet widely available (if at all) in Thailand. Most labs here still use older forms of test which are nto as accurate.

 

Whatever type of test for occult blood is done, if positive it will have to be followed by a colonoscopy.

 

It is also necessary to do such testing every year as opposed to the once in 10 year schedule for colonoscopy.

 

 

 

 

[scubascuba3]

1 minute ago, Sheryl said:

FIT is a newer test nto yet widely available (if at all) in Thailand. Most labs here still use older forms of test which are nto as accurate.

 

Whatever type of test for occult blood is done, if positive it will have to be followed by a colonoscopy.

 

It is also necessary to do such testing every year as opposed to the once in 10 year schedule for colonoscopy.

 

 

 

 

Every 10 year not 5 years? I think that consultant at RSU Healthcare in Bangkok said 5 years

[Sheryl]

23 minutes ago, scubascuba3 said:

Every 10 year not 5 years? I think that consultant at RSU Healthcare in Bangkok said 5 years

 

Every 10 years unless high risk. High risk would include positive family history or prior colonscopies finding multiple polyps or one or more large polyp (>10mm).

 

Signmopidoscopy (as oppoied to colonoscopy) is every 5 years.

[retiree]

On 10/29/2021 at 5:30 PM, Pravda said:

However the doctor said if he writes up to be admitted which usually means spending a night at the hospital the insurance will fork out the costs.

I had the endo- / colonoscopy party at a large hospital in Bangkok several years ago.  No assumption or mention of overnight stay.   Local insurance (Aetna) approved it in advance and paid in full.  I have in-patient coverage only, btw -- no out-patient.   Pretty easy sailing at both ends, and "come back in 10 years" sounded pretty good.

-- Retiree

[dinga]

On 10/29/2021 at 5:46 PM, Sheryl said:

 

Except for  PSA, absolutely not worthwhile - none of these tests are suitable for cancer screening. Many false negatives and also positives due to conditions other than cancer. Private hospitals love these tests as they lead to a lot of other, expensive (and often unnecessray) tests.Not a single public health authority in the world recommends AFP, CEA and CA-199 for mass screening.

Thanks Sheryl.  Appreciate some more general advice.  In 2005, I had bowel cancer which was excised, and I underwent radiation & chemo treatment - thus far as is good with no re-occurance.

 

Colonoscopies were recommended every 5-10 years (I'm now working on 7 years since the last one), and I check CEA levels every 6 months (I've dispensed with the annual specialist's visit to Bkk and finger up the coit).  Does that approach sound half reasonable?     

[Sheryl]

13 hours ago, dinga said:

Thanks Sheryl.  Appreciate some more general advice.  In 2005, I had bowel cancer which was excised, and I underwent radiation & chemo treatment - thus far as is good with no re-occurance.

 

Colonoscopies were recommended every 5-10 years (I'm now working on 7 years since the last one), and I check CEA levels every 6 months (I've dispensed with the annual specialist's visit to Bkk and finger up the coit).  Does that approach sound half reasonable?     

 

Not really. I am quite surprised by the 5-10 year recommendation for colonoscopy.

 

"Any patient who has had curative surgery for a polyp or colorectal cancer has approximately double the risk for developing new polyps. These patients need to have their first colonoscopies 1 year after surgery, a follow-up colonoscopy 3 years later, and subsequent colonoscopies at no less than 5-year intervals. If any new polyps or lesions are found, patient surveillance should be modified appropriately."

https://fascrs.org/patients/diseases-and-conditions/a-z/colon-and-rectal-cancer-follow-up-care-expanded-ve

[dinga]

17 minutes ago, Sheryl said:

 

Not really. I am quite surprised by the 5-10 year recommendation for colonoscopy.

 

"Any patient who has had curative surgery for a polyp or colorectal cancer has approximately double the risk for developing new polyps. These patients need to have their first colonoscopies 1 year after surgery, a follow-up colonoscopy 3 years later, and subsequent colonoscopies at no less than 5-year intervals. If any new polyps or lesions are found, patient surveillance should be modified appropriately."

https://fascrs.org/patients/diseases-and-conditions/a-z/colon-and-rectal-cancer-follow-up-care-expanded-ve

Thanks so much Sheryl.  I have had quite a few of them at those earlier intervals, but sounds like I'd better move the next one forward pronto (in fact the last one was done 6 years ago).

 

 

[The Hammer2021]

On 10/29/2021 at 6:01 PM, scubascuba3 said:

Very useful I missed the Stool occult blood test which is available at a local clinic, it seems this is the same as a FIT test which is what is used by the UK NHS for bowel cancer screening I mentioned in the OP so it's at least a start

It only checks for blood. It doesn't check for cancer does it?

[scubascuba3]

2 hours ago, The Hammer2021 said:

It only checks for blood. It doesn't check for cancer does it?

Yes blood, so in the prep notes it says don't have one if gums bleeding, hemorrhoids and others mentioned

[dinga]

On 11/1/2021 at 11:05 AM, dinga said:

Thanks so much Sheryl.  I have had quite a few of them at those earlier intervals, but sounds like I'd better move the next one forward pronto (in fact the last one was done 6 years ago).

 

 

Thanks again Sheryl - done & dusted; results in = piece of mind for another 5 years