Below is a verbatim transcript (and additional embedded
of my investigative report in four parts. You may find them handy if you are
troubled by my accent, or speed of delivery, or too many facts,
or small video size, or poor connection to the Internet, or your office
restrictions on watching videos, or what have you.
Part I. The Anatomy Of A Deadly Deception
My name is Konstantin Monastyrsky. I am a medical
writer [bio], performance nutrition consultant, and an expert in forensic
nutrition [about]. This new field of life science investigates connections
between supposedly healthy foods and undeniably lethal diseases.
Colorectal cancer is one of such diseases. It is the
most dominant and the deadliest nutrition-related cancer — close to one
hundred sixty thousand new cases diagnosed annually in the United States
So our desire to prevent it isn't surprising,
especially when we are told that regular colonoscopies after age fifty
make colorectal cancer "more than 90% curable — but only if you get
tested in time." 
Actually, this is a lie! Screening colonoscopies do not
prevent or materially reduce anyone's risk of colorectal cancer
regardless of age. And if anything, they may actually increase your
overall risk of cancer, and not just colorectal.
Here are the true facts:
First, according to the American Cancer Society, up
till now… “…There are no prospective randomized controlled trials of
screening colonoscopy for the reduction in incidence or mortality of
colorectal cancer.” 
The National Cancer Institute is even more explicit:“…it is not yet known for certain whether colonoscopy
can help reduce the number of deaths from colorectal cancer.” 
This means that the 90% cure
rate figure cited by Ms. Couric back in 2000 is pure fiction. It also
means that most of the fourteen million plus screening colonoscopies
 performed annually in the United States to the tune of twenty to
thirty billion dollars aren't recommended on the basis of rock-solid
research or clinical indications, but on the willful misinformation of
the American public, consumer fraud in other words…
Second, according to the analysis of actual outcomes,
‘screening colonoscopies‘ are essentially useless: “The patients in all the studies had at least one
adenoma detected on colonoscopy but did not have cancer. They developed
cancer in the next few years, however, at the same rate as would be
expected in the general population without screening.”
Third, colonoscopies aren't as safe and simple as you
may think or are led to believe: “Colonoscopy can result in significant harms, most
often associated with polypectomy, and the most common serious
complication is post-polypectomy bleeding”, and “Another
significant risk associated with colonoscopy is perforation,” of the
colon, that is... 
And that is even before taking into account your
stress, anxiety, false positives, frequently missed polyps and tumors ,
and all of the usual recovery-related complications, such as infections,
constipation, diarrhea, hemorrhoids, diverticulitis, and others.
But all these risks pale in comparison with 'computed
tomography,' known as virtual colonoscopies. Incredulously, instead of
preventing your risk of cancer, they actually increase it by exposing
you to five to ten millisieverts of x-ray radiation required for just
one abdominal scan.
According to the United States Food and Drug
Administration... "This range is not much less than the lowest doses
of five to twenty millisieverts received by some of the Japanese
survivors of the atomic bombs."
Goodness gracious... Radiation levels from a single
virtual colonoscopy are similar to the atomic bomb exposure in
Hiroshima, even though, according to The National Cancer Institute: “Whether virtual colonoscopy can reduce the number
of deaths from colorectal cancer is not yet known.” 
But the really frightening part comes next: "This increase in the possibility of a fatal cancer
from radiation can be compared to the natural incidence of fatal cancer
in the U.S. population, about 1 chance in 5."
In other words, a single,
virtual colonoscopy turns an otherwise absolutely healthy person with a
lifetime risk of colon cancer under 5% into a cancer-prone sitting duck
with a 20% risk of contracting any type of cancer.
Author's commentary: Please note that my statement
above is incorrect. According to the FDA document I cited, the
risk of fatal cancer from a single CT-related radiation exposure isn't 1
in 5 but 1 in 2000. Neither myself, nor my editors, nor the numerous
readers of this material have noticed this error until December
5th, 2013, when I received a note from a concerned reader who has noted
my error. Here is what the actual text had said:
CT examination with an effective dose of 10 millisieverts (abbreviated
mSv; 1 mSv = 1 mGy in the case of x rays.) may be associated with an
increase in the possibility of fatal cancer of approximately 1 chance in
2000. This increase in the possibility of a fatal cancer from radiation
can be compared to the natural incidence of fatal cancer in the U.S.
population, about 1 chance in 5. In other words, for any one person the
risk of radiation-induced cancer is much smaller than the natural risk
of cancer." [link]
This is a classical case
of "confirmation bias," and I regret misinforming readers by making this
unfortunate error. That said, I still think that anyone exposing
himself/herself to CT scans in the situations that aren't
life-threatening, is making a grave mistake, especially when this
"anyone" is a child. The lifetime increase of cancer risk related to
radiation isn't linear, but, as a note below explains, "cumulative and
exponential." It is even more so in the era of near-constant exposure to
cell towers, police and aviation radars, Wi-Fi routers, and the
Fukushima- and Chernobul-like environmental disasters.
Furthermore, I don't have
any proof to the contrary (and nobody does for sure), but I believe that
the claim that the equivalent to getting exposed to 500 regular chest
x-rays carries only 1 in 2000 risk of cancer is not true. Feel free to
call me a conspiracy nut, but if that risk would be, indeed, that low,
people who work in radiology centers wouldn't have to hide themselves
behind lead-reinforced walls and wear radiation dose monitors while at
odds, you are actually two hundred times safer living next-door to a
Russian-built nuclear power plant your entire life than having just one
single CT scan. 
And since virtual colonoscopies are now recommended
every five years, your cumulative exposure to radiation by the time you
reach your seventieth birthday will be similar to witnessing not one,
not two, not three, not even four, but five nuclear blasts, and your
risk of developing any kind of cancer will be five out of five, or
Author's commentary: The statistical representation of repetitive risk isn‘t a simple linear
sum of the totals, but a regressive calculation. In other words, five
identical events that increase the risk of an adverse outcome by 20% each,
will increase the total risk of adverse outcome to 67%, not 100%, as I
rhetorically suggested above.
This regressive analysis of mere risk, however, doesn‘t apply literally to x-ray radiation exposure from periodic CT
scans alone. In this case, the rate of cancer risk increase is cumulative and
exponential, because each successive irradiation of aging
body carries a far greater risk than the previous one five years before.
In other words, the true risk of any cancer from
five successive virtual colonoscopies between the ages of 50 and 70 is
far greater than 100%. How greater — God only knows, — and I don‘t
recommend anyone to attempt find this out the hard way!
Not surprisingly, the actual incidence of colorectal
cancers in the United States has grown by 30,000 more cases annually, a
whopping 22% increase in just eight short years. (The incidence of colorectal cancers in the
United States has increased from an estimated 129,400 new cases in 1999
to 158,410 in year 2007 [11,
Author's commentary: Someone sent me
a rather nasty comment suggesting that this increase in the incidence of
colorectal cancer demonstrates the success of colonoscopies in detecting
and treating early cancers. It very well maybe true. There are,
however, four serious problems with this argument:
— First off, the patients are urged to undergo
screening colonoscopies to PREVENT colon cancer occurrence with 90%
certainty, not to DETECT early colon cancer. For that, you can take a
safe, simple, and more economical blood test as often as you like, and without incurring
any risk of either getting killed or injured by colonoscopy, or missing
a cancer in progress. And I recommend that much in part II for anyone
with propensity for hypochondria.
— Second, early detection of asymptomatic colorectal cancer may
actually shorten patient's life, because it automatically triggers inevitable
biopsy, surgery, and chemotherapy. Otherwise it takes about 10 years for
most colorectal tumors to become symptomatic (i.e. large enough to cause
problems that requires surgical intervention).
— Third, if you get operated on for a two year-old
tumor, your chances of premature death are far greater than if you
get operated on for a ten year old tumor eight years later. And
you get to live about the same age-adjusted lifespan after the
treatment. Thus, doing nothing buys you at least an extra eight years of normal
life and care-free bliss!
— Fourth, there is greater than 95% chance that you
will succumb to any other terminal disease or old age before colorectal
cancer has a chance to kill you, while any attempt to eliminate that 5%
risk of colorectal cancer with screening colonoscopies increases your
cumulative risk of death far greater than 5%. To learn why, please watch
parts III and IV.
So ask yourself this simple question: would you
rather take a 5% chance of dying from a large colorectal tumor eight years from now; or undergo surgery
and chemo today, wear a colectomy bag for the next eight years, and
most likely die anyway before eight years are up from some other cancer, stroke, or heart attack
caused by post-treatment complications?
In terms of cancer, this sharp upsurge is considered an
epidemic of catastrophic proportions. So why, then, do doctors recommend colonoscopies if
they are unproven, ineffective, risky, and unreliable?
A rotating pile of money, “Money,
money...” jingle in the background from the musical “Cabaret.”
That is the answer to that question!
Doctors‘ profit motives aside, Katie Couric isn't
exactly a benevolent Samaritan either. She began urging Americans to get screened for colon
cancer while she was [being] employed by General Electric, the owner of
GE happens to manufacture and sell CT scanners used for
virtual colonoscopies. Since each of these room-sized contraptions [link]
costs upward of three-and-a-half million dollars, what is a better way
to keep them 'minting money' than an indirect endorsement by a big TV
Lo and behold, her handlers ruthlessly exploited her
husband's unfortunate death from colon cancer to promote colonoscopies.
Because Ms. Couric never disclosed her connection to GE Healthcare - a
seventeen billion dollar subsidiary of GE and a sister company of NBC [link]
— unsuspecting Americans embraced her story, and the number of
screenings jumped from under one million before her famous televised
colonoscopy in year 2000 to around fourteen million today.
Adding to this hypocrisy, Jay Monahan - Ms. Couric's
late husband - passed away at age forty two, eight years before a first
screening is even recommended. This, unfortunately, means that neither
him nor anyone else in his predicament would have likely been saved…
Based on all the above evidence, I pleaded with Mr.
Couric first by mail [link], second on her blog [link],
and finally on my site,
to stop endorsing or recommending colon cancer screening to 95% of
Americans, who are in a low-risk group. Regretfully, she ignored my
pleas and never responded.
One change I noticed… After Ms. Couric left NBC for
greener pastures at CBS, she no longer refers to the 90% cure rate [link].
Now, it is just a measly 5% reduction of "colon cancer death."
Katie Couric: “Colon cancer is the second leading cancer killer. But if
it is detected early, it has better than 90% cure rate.” (from
And seven years later…
Katie Couric: "Colon cancer
death are down almost 5% among men, and 4.5 among women."
Sadly, even this small reduction isn't likely related
to screenings, and I discuss its probable reasons [link] on this video's
After this report had already been taped, the Annals of Internal Medicine — a preeminent publication of the American College of Physicians — released a new research paper concerning the considerable failure of
screening colonoscopies to detect and prevent colorectal cancer,
particularly in the right colon.
commentary by Dr. David Ransohoff, the Professor of Medicine at the
University of North Carolina at Chapel Hill, states the following :
“A goal of avoiding all deaths from colon cancer
may be admirable, but we do not have evidence that we can achieve it.”
“Although colonoscopy is generally safe, it is
still an invasive procedure with a 0.2% rate of serious complications
—10 times higher than for any other commonly used, cancer-screening
test. Repeated examinations over time may incur a substantial cumulative
rate of complications, not even counting hard-to-detect complications
(if they occur), such as silent myocardial infarction [heart attack — KM].”
“Colonoscopy is an effective intervention, but, as
Baxter and colleagues suggest, we must realize that current evidence is
indirect and does not support a claim of 90% effectiveness.”
— So, who, then, should get screened for colon cancer,
You‘ll find the answer to this question in the second
part of this investigative report.
Author's commentary: After watching/reading the above section, you may ask yourself this completely sensible question:
— How can a scornful Ms. Couric claim a 90%
reduction of colon cancer risk while an indignant Mr. Monastyrsky claims
no reduction, only an increase?
Oh, that's easy… Just like a horse race, any
clinical study can be easily fixed to deliver the desired outcome either
by falsifying the trial design, or by manipulating outcome statistics,
or both. That's how this 90% figure came about, and until this day I
can't locate the original sourcing for this figure.
From this point on, these scams are managed using
well-learned and well-practiced formula:
● By using
cherry-picked references from prestigious medical journals. The articles
in many of these journals aren't generally available to the general public,
so it's easy to obscure undesirable outcomes and conclusions;
● By donating
money to not-for-profit associations, whose sole function is to promote
their donors. The National Colorectal Cancer Research Alliance was co-founded
by Katie Couric specifically for this purpose — to funnel “blood money” to promote screening colonoscopies.
● By hiring so-called
“expert spokespersons” who will endorse and champion anyone willing to
pay up, and so on.
And this obfuscation was particularly easy to
accomplish in cases of screening colonoscopies, because, unlike drugs,
medical equipment, or lab tests, the diagnostic protocols do not, I
repeat, do not require anyone's approval or oversight.
As far as my indignation goes, once you too realize that
screening colonoscopy can't reduce anyone's risk of colon cancer for the
same fundamental reasons you can't crossbreed a cat with a dog, you'll
no longer question it.
Part II. Turning A Probable Death Sentence Into A Manageable Risk
Lets begin by addressing the last question from Part I: Who should get screened for colorectal cancer, if anyone at all?
Well, for starters, lets keep the mortality rate from
colorectal cancer in perspective. Even a person in a high-risk group is
12 times as likely to die from heart disease; 10 times — from any other
cancer, 6 times — from a medical error , 3 times from stroke, and
twice as likely to die from an accident… 
Considering these stats, the paranoia whipped up by Ms. Couric and her
paymasters wasn't, obviously, about saving your life, but about making a
You have also learned by now that regular screenings 5
or 10 years apart are more or less useless, and, adding insult to
injury, that virtual colonoscopies may cause all kinds of other cancers.
But even if you ignore all these facts, and decide to
get screened as often as every year, consider the outcome of the
Minnesota Colon Cancer Control Study . It included 46 thousand patients between the ages of 50
and 80 and lasted for a whopping 18 years.
But in the end, it
demonstrated only 0.62% reduction in the incidence of colorectal cancer.
Statistically speaking, a difference this tiny was purely a chance
Another prominent trial, known as the Telemark Polyp
Study I ,
have been equally discouraging. The absolute difference in the incidence
of colorectal cancer between screened patients and controls was only 2%,
while the mortally rate from all causes in the screened group was 157%
higher than among those who hadn't been screened (In the video I
mistakenly indicate 57% instead of 157% — KM) .
Here is what it all means:
— First, If you
are in a low-risk group, regular screenings will very likely increase
your chances of death or disease from all other causes;
—Second, If you
are in a high-risk group, even annual screenings aren't materially
— And third, if screenings are indeed useless, then a
strategy of life-long prevention is
the only viable way to escape colorectal cancer, especially for
These three conclusions bring up three equally crucial
— First, how do you determine if you or your loved ones
are at risk?
— Second, is it actually possible to prevent colorectal
— And, third — if it is, indeed, possible to prevent
it, what should you do?
So lets address the first question first:
— Are you or your loved ones in the high-risk group
for colorectal cancer?
I know the answer to this question better than most
because I myself have a genetic predisposition to colorectal cancer
through my Ashkenazi Jewish heredity and a long history of colorectal
disorders. Also, my wife's dad had colon cancer, and this places Tatyana
in the high risk group too. And both of us are well past fifty.
Considering this backdrop, we are just as scared as
anyone would be in our shoes. So, if you are a confirmed hypochondriac, you may
definitely pursue safe and non-invasive stool tests for colon cancer
markers as often as you like.
Stool Tests For Colon Cancer Markers:
— Guaiac [pronouncedgwahy-ak] fecal occult blood test (gFOBT);
— Stool DNA test (sDNA);
— Fecal immunochemical test (FIT)]
If these tests prove positive or there are any
unexplained symptoms, you should definitely undergo conventional
And now, lets address the next question:
— Is it possible to prevent colorectal cancer?
Absolutely! The majority of colorectal cancers aren't
hereditary, and the majority of people in the high-risk group never
develop one either. This means that colorectal cancer is connected to
lifestyle factors just like lung cancer is connected to one's smoking.
Eliminate these risk factors, and you'll reduce your chances of getting
hit with colorectal cancer for the same reasons not smoking reduces the
risk of lung cancer. This ain't rocket science, that's for sure…
Just like with any other cancer, this is not a
foolproof enterprise, but for anyone in the high risk group, a strategy
of life-long prevention turns a probable death sentence into a
manageable risk, and for anyone in the low risk group it just about
eliminates the possibility.
Finally, lets address the last question:
— What should you do to eliminate as many risks of
colorectal cancer as humanly possible?
There are several external, and, therefore,
well-controllable risk factors. They are, respectively:
wrong diet, malnutrition, poor bowel habits; side effects of drugs; poor
immunity; common colorectal disorders, such as IBS, inflammatory bowel
disease; damaged intestinal flora, and some others. To a large extent, all of them are interdependent. This
means fixing one positively affects the rest, while neglecting one makes
all others more damaging.
To sort out and eliminate all of these risks, please
visit my web site GutSense.org. In addition to colon cancer prevention,
it also addresses chronic constipation, diarrhea, irritable bowel
syndrome, diverticular disease, and related complications. These widespread disorders commonly precede polyposis — the formations of polyps that may eventually turn into
Obviously, to prevent polyposis, you must eliminate
these conditions first. Otherwise, you can zap polyps all you want, but
as long as their causes are still there, new ones will pop-up long
before your next screening. That, essentially, explains why
colonoscopies are so ineffective.
The most tragic aspect of this sad story is also the
deadliest… The promoters of this fraud continue to intimidate
unsuspecting Americans and their well-meaning doctors into the false
belief that 'screening colonoscopies' are the only viable way of
preventing colorectal cancer:
Voice of Katie Couric from March, 2007 video [YouTube
“A colon is it's own container. If you can remove the
polyp, even before it's cancerous, then you literally nip the disease in
Voice of Konstantin Monastyrsky:
goodness sake, Ms. Couric, please stop lying! The truth is (the
following four slides displayed while Mr. Monastyrsky reads highlighted
From the National Cancer Institute web site
“…it is not yet known for certain whether
colonoscopy can help reduce the number of deaths from colorectal
From 'A Cancer Journal for Clinicians' :
“…There are no prospective randomized controlled
trials of screening colonoscopy for the reduction in incidence or
mortality of CRC [colorectal cancer - KM].”
From The New York Times :
“The patients in all the studies had at least
one adenoma detected on colonoscopy but did not have cancer. They
developed cancer in the next few years, however, at the same rate as
would be expected in the general population without screening.”
From the Annals of Internal Medicine :
“A goal of avoiding all deaths from colon cancer
may be admirable, but we do not have evidence that we can achieve it.”
“Colonoscopy is an effective intervention, but, as
Baxter and colleagues suggest, we must realize that current evidence is
indirect and does not support a claim of 90% effectiveness.”
As a result, most people over fifty do nothing to
materially prevent it, except praying for the best, and waiting in fear
for yet another useless screening that may harm them even more.
I hope this isn‘t you!
Thank you for watching!
I wish you and your family good luck and good health!
Part III. Why Screening Colonoscopy Increases the Risk of Colorectal Cancer
The whole premise of using screening colonoscopy to
prevent colon cancer is built around the idea of polypectomy - a medical
term for locating and removing precancerous polyps inside the colon,
just like explained in this advertorial by “doctor” Couric:
Voice of Katie Couric from March, 2007 video [link]:
“If you can remove the
polyp, even before it's cancerous, then you literally nip the disease in
But that is not what the polypectomy actually delivers:
● First, an estimated 95%
of all polyps are benign, they will never become cancers, so removing
them makes just as much sense as zapping the moles off your buttocks to
● Second, not all
colorectal cancers are preceded by detectable polyps. It is believed an
even larger share of colon cancers start from flat lesions that no one
is suggesting to remove, even though they are considered five time
as cancerous as large polyps....
● Third, removing polyps
or even doing biopsies releases cancer cells into the blood stream and
the colon's lumen. In turn, these cells may seed all other cancers
throughout the body. This phenomenon, of course, is well known to cancer
specialists. How do you think researchers infect experimental animals
with cancers – they simply collect cancer cells from a donor and inject
them into any desired site. In essence, taking out a precancerous polyps
may be riskier than leaving it alone.
● Fourth, it is a well
established fact that new polyps spring like weeds following
polypectomy, and probably for the same reason I just mentioned – the
release of cancer cells into the body. Unfortunately, as the number of
polyps goes up, so do the odds of one of them eventually turning into a
● Fifth, even the most
thorough endoscopists may miss up to 30% of detectable polyps, and the less
rigorous routinely miss up to 60%, including actual cancer tumors. All
of them, regardless of skill or attention, miss 100% of all polyps in the
right colon. Come to think of it, missing polyps may not be such a bad
thing, considering just how risky their removal may be.
● Sixth, the average age
for colorectal cancer diagnosis is 72 years [close to the average
lifespan for American men, and just a few years short of the average
lifespan for American women – KM.] So commencing invasive screening and
polypectomies in asymptomatic people at age 50 is just as absurd as
taking contraceptives after menopause;
● Finally, seventh, if
you have poor blood coagulation, or take regular aspirin as most people
past 50 do, or are on a blood thinner such as warfarin [generic name for
brands known as Coumadin, Jantoven, Marevan, and Waran –
ed.], polypectomy profoundly increases your risk of death from hard to
detect internal bleeding which may lead to ischemic stroke, myocardial
ischemia, cardiac arrest, or sudden cardiac death.
So, do the simple math to realize just how pointless
and dangerous this whole charade is: almost all polyps are benign;
removing them is riskier than leaving them alone; more than half of all
polyps are undetectable; most cancers don't start from polyps but
lesions; you are likely to die from old age before colon cancer strikes
you; and your risk of dying from a colonoscopy-related complications may
exceed your risk of ever getting colon cancer in the first place.
Or, how about this undeniable fact for proof: If
screening colonoscopies and resulting polypectomies were, indeed,
effective, with about half of Americans past age fifty getting screened,
we should have enjoyed at least a 50% reduction in the incidence and
mortality of colon cancer. But, instead, we have a 22% increase in
incidence, while the number of deaths remains practically the same. If
that is not a proof, what, then, is?
Author's commentary: True, in a best case scenario, screening colonoscopy
may catch a colorectal cancer already in progress. But even this chance
is actually slim because a 5 to 10 years interval between screenings
turns this enterprise into a veritable Russian roulette. And even when a small, early tumor is caught in time, a
mandatory biopsy releases cancer cells into the body, setting you up for
metastases all over, for unavoidable chemotherapy, and for all other
In no way am I denying or obscuring the tragic aspects
of colon cancer. It is a costly, devastating, and deadly disease. All I am saying is this: Look at the facts - screening
colonoscopies make colon cancer even more costly, even more devastating,
and even more deadly!
And they do absolutely nothing to prevent colon cancer.
To the contrary – by creating a false sense of security, screenings make
most people even more reckless and even more exposed to all other
cancers. Indeed, why bother with prevention, when you believe
that a single doctor's visit every five or ten years will “nip the
disease in the bud!” with 90% certainty…
Finally, everyone keeps asking me the same question
over and over again:
– But how come, Mr. Monastyrsky, does all this
information come from you, and not from the doctors?
Let me quote 'The New York Times' for you:
And this is particularly true for cancer, because there
is no business more profitable than the cancer business – between
diagnosis and death, an average well-insured patient is worth $200,000 to
$300,000 to doctors, hospitals, diagnostic labs,
and big Pharma. The average healthy patient is worth exactly nothing.
Thank you for watching!
Please click the orange Subscribe button in the upper right hand corner [this applies to videos
watched on YouTube], so you don't miss the next episode. Information like this
may actually save your life!
Part IV. Why Screening Colonoscopy Increases Mortality?
It is an open secret that screening colonoscopies
As far back as in 1996, the Telemark Polyp Study 1
demonstrated that two-and-a-half times as many screened patients had
died from all other causes than had been presumably saved from colon
cancer by the colonoscopy in the first place.
Author‘s commentary: It‘s worth noting
that the Telemark‘s colonoscopies were performed “by the book” at a
major metropolitan hospital by experienced GI surgeons, and without any
profit considerations or time constraints. Alas, the average endoscopist
at a local colonoscopy mill compares to these surgeons just like the
presidential physician at the White House compares to a part-time doctor
at a neighborhood walk-in clinic, and so do the outcomes.
In no way I wish to disparage the hard work of any
doctor at any clinic regardless of its income potential or location. The
difference lies in the amount of time and attention allotted to each
individual patient, while the President is the one and only patient.
This factor alone reduces inadvertent medical errors by a mile.
Just like with any abdominal surgery, there are four
primary factors that contribute to colonoscopy-related complications.
These are the side effects of colon prep, the aftermath of general
anesthesia, endoscopy-related surgical wounds, and medical errors.
Lets review them one-by-one, with emphasis on risk and
I‘ll start with the side-effects of colon preparation.
Normally, the large intestine is filled with fecal matter throughout its
entire length. To have an unobstructed view, all feces must be purged
clean with a laxative, a procedure known as “colon prep” or “lavage.”
Severe dehydration, kidney damage, and bowel movement disruption are the
most common side effects of this step.
With the number of screening colonoscopies growing, the
problem became significant enough to get the Federal Drug Administration
into the action:
“FDA has become aware of reports of acute phosphate
nephropathy, a type of acute kidney injury, associated with the use of
oral sodium phosphate products (OSP) for bowel cleansing prior to
colonoscopy or other procedures.”
Over 85,000 people die annually from kidney failure
[link] — that is almost 50% more than from colorectal cancer. I believe
many of these deaths have been precipitated by a careless and damaging
Author‘s commentary: Kidney damage is
an especially high hazard for tens of millions of older Americans with
diabetes and prediabetes who may already have weakened kidneys. If you
are taking the most common hypertension and heart disease medicines, you
too are at increased risk.
According to the article entitled "Acute phosphate nephropathy following oral sodium phosphate bowel
purgative: an under-recognized cause of chronic renal failure." (J Am Soc Nephrol
16:3389-3396, 2005), the acute phosphate
nephropathy — that‘s a term for kidney damage by an osmotic laxative
used for prep — may occur in up to 1 in 1000 patients who receive oral
sodium phosphate products.
This means that the annual rate of kidney damage
related to screening colonoscopy is at least 14,000 cases. Because
kidney damage is difficult to detect quickly, the actual rate may be
higher. I came across more recent articles that indicated the damage
rate as high as 1%, or 140,000 cases.
The prep-related dehydration may result in dizziness,
syncope, ischemic stroke, blood clotting, sudden cardiac death, a fall
or an accident, medication overdose, and other complications. The death
rate related to these side effects is not known.
Bowel movement disruption following colonoscopy
commonly leads to chronic constipation, severe diarrhea, diverticulitis,
and bowel obstruction. All of these conditions constitute a primary
cause of inflammatory bowel disease (Crohn's disease and ulcerative
colitis — ed.), that alone increases the risk of
colon cancer by 32 times!
That‘s right – 3,200%.
Now, lets review the most common side-effects of
Author‘s commentary: If you have ever
experienced even mild flatulence, you must know what the pain from gas
pressure feels like. To keep the colon wide-open, doctors pump
compressed air into the colon at several times the pressure of gases.
For this and other reasons colonoscopy without anesthesia is an
extremely painful procedure.
Unfortunately, all types of general anesthesia are
extremely risky because it affects blood circulation, heart and lung
function, and turns off immunity. Just the confirmed rate of severe
cardiovascular risk from general anesthesia for low-risk surgical
procedures, such as colonoscopy, ranges from 0.27% to 1.1% within the
first six days after the surgery.
Author‘s commentary: According to the
same source, “Severe cardiac complications included cardiac death,
cardiac arrest, myocardial infarction, ventricular tachycardia, and
fibrillation and pulmonary edema.”
That‘s why an anesthesiologist or nurse
anesthesiologist must be present for the entire length of the
colonoscopy in order to administer the anesthetic and monitor your vital
Deep vein thrombosis and pulmonary embolism is another
common side effect related to general anesthesia, even a brief one.
Pulmonary embolism causes or contributes to up to 200,000 deaths
annually in the United States [link].
Author‘s commentary: Deep vein
thrombosis (DVT) is, essentially, blood clotting due to immobility and
the slowdown of blood circulation, caused by the anesthetic. The risk of
clotting increases with the anesthesia‘s duration. That is why a
thorough colonoscopy lasting an hour or more is much riskier than the
assembly-line hack jobs that usually take under 10 minutes. It may take
weeks for a clot to dislodge and travel up to the lungs, so it‘s hard to
connect this outcome to the colonoscopy.
An estimated 25% of all people develop chest infections
after general anesthesia, and many older people die weeks or months
later from acute pneumonia. Mortality rate from pneumonia is 5%, and
about 60,000 people die annually — slightly more than from colorectal
Finally, lets account for surgical wounds and medical
Accidental colon perforation with endoscope, injuries
from air insufflation and/or endoscope, and bleeding from polyp removal
with a wire loop are the primary immediate complications of the
colonoscopy procedure itself.
According to the “Complications of Colonoscopy in an
Integrated Health Care Delivery System” report, the rate of
complications from conventional diagnostic colonoscopy, such as colon
perforation, bleeding, and diverticulitis, reported at 5 in 1,000, or
Author‘s commentary: The above study
authors indicated that “much of the information on complications has
come from studies or referral centers and might not reflect what
actually happens in the general community.” This is coded language for
“actually, it may be much higher, but we don‘t know just how much
According to numerous published reports, only [up to —
ed.] 20% of
all medical errors are ever reported. With this in mind, the actual rate
of screening colonoscopy complications may be as high as 20 in 1000, or
Author‘s commentary: Since the colon‘s
environment isn‘t exactly “dry and clean,” an infection often occurs at
the polypectomy site and in diverticula, and some of them may require
follow-up abdominal surgery to remove the affected portion of the colon.
Finally, don‘t ignore the release of cancer cells into
the body caused by polypectomies and biopsies, particularly among
younger people. It takes ten years for one polyp in twenty to grow into
a cancer tumor. But it takes only a fraction of this time for these
cells to turn into all other cancers once they are released into the
blood by the very doctor who is trying to protect you from colon cancer.
Our final conclusions “ain‘t” pretty:
— Up to 14,000 potential deaths from kidney damage.
That‘s a low-ball estimate.
— The number of deaths from pulmonary embolism
related to general anesthesia isn‘t known, but it may be considerable.
Knee replacement surgery, for example, causes 1 case of pulmonary
embolism per 100 surgeries [link]. In the case of colonoscopy, even one
case in 500 is enough to kill 7,000 people annually.
— At least 70,000 patients get injured by colonoscopy
according to actual reports. The unreported injury rate may be close to
280,000 or 2%. Considering the type of complications — internal
bleeding, colon perforation, diverticulitis, and infections — many of
these patients end up dead!
— The annual incidence of colorectal cancer in the
United States is up by 30,000 more cases since the colonoscopies begun
in earnest in the year 2000. Most likely this increase is directly
related to colonoscopy‘s complications. At least 10,000 patients will
die shortly after the diagnosis.
— The potential long-term death toll from all other
cancers caused by polypectomy-related contamination, and radiation
exposure from virtual colonoscopies will be in the millions.
— Lives saved by screening colonoscopy? Even
according to Katie Couric, who has a penchant for exaggeration, just
2,500 a year… — In this statistical and logistical context, considering
a screening colonoscopy for prevention is akin to committing suicide at
the age of 50 to prevent dying from colon cancer by the age 72.
Knowing all this information now, would you bet your
bet your life, health, and future on a screening colonoscopy instead of
elementary prevention? I hope not.
to view the source site or document in the new window (when available).
The references for this essay were compiled in December 2008 —February
2009. Some of the links may not match at a later date because publishers
may revise their web sites. In this case, try searching cached pages on
Google, or contact the respective publishers.
1. American Cancer Society. Cancer Facts & Figures
2007. Atlanta: American Cancer Society; 2007. [link]
2. The National Colorectal Cancer Research
Alliance, Don't end up saying "if only." Get tested." [link]
3. Levin, B., at al.; Screening and Surveillance for
the Early Detection of Colorectal Cancer and Adenomatous Polyps, 2008: A
Joint Guideline from the American Cancer Society, the US Multi-Society
Task Force on Colorectal Cancer, and the American College of Radiology
CA Cancer J Clin 2008 58: 130-160 [link]
4. Colorectal Cancer Screening; National Cancer
Institute; Oct 2008; [link]
5. Seeff LC, et al.; How many
endoscopies are performed for colorectal cancer screening? Results from
CDC's survey of endoscopic capacity. Gastroenterology. 2004;127:
6. Study Questions Colonoscopy Effectiveness; The New
York Times; G. Colata; Dec 14, 2006; [link]
7. Barclay, R., at al.; Colonoscopic Withdrawal
Times and Adenoma Detection during Screening Colonoscopy N Engl J Med
2006 355: 2533-2541
8. What are the Radiation Risks From CT?; U.S. Food
and Drug Administration; Center For Devices and Radiological Health;
August 6th,2008; [link]
9. Jerry M. Cuttler; What Becomes of Nuclear Risk
Assessment in Light of Radiation Hormesis? Proceedings of the 25th
Annual Conference of the Canadian Nuclear Society, Toronto, June 6-9,
10. Rudy, D, et al.; Update on Colorectal Cancer;
American Family Physician; March 15, 2000; [link]
11. Cancer Facts & Figures, 2007; Atlanta: American
Cancer Society; 2007, page 4 [link]
12. Ransohoff, D.; How Much Does Colonoscopy Reduce
Colon Cancer Mortality? Ann Intern Med 2008; 60520-308. [link]
13. D. W. Bates; et al.; Incidence of adverse drug
events and potential adverse drug events. Implications for prevention.
ADE Prevention Study Group JAMA. 1995;274(1):29-34. [link]
14. FASTSTATS A to Z; National Center for Health
Statistics, Centers for Disease and Prevention; [link]
15. Mandel, J, at al.; The Effect of Fecal
Occult-Blood Screening on the Incidence of Colorectal Cancer; N Engl J
Med 2000 343: 1603-1607 [link]
16. Thiis-Evensen E, et al.; Population-based
surveillance by colonoscopy: effect on the incidence of colorectal
cancer. Telemark Polyp Study I.; Scand J Gastroenterol. 1999
The following references apply to the sources mentioned
on the Home page and throughout this section:
— Complications of Colonoscopy in an Integrated
Health Care Delivery System; T. R. Levin, W. Zhao, C. Conell, L. C.
Seeff, D. L. Manninen, J. A. Shapiro and J. Schulman; Ann Intern Med
2006; 880-886. [link]
— Virtual Colonoscopy Misses Nearl One Third of
Lesions; The proceeds of the 68th annual scientific meeting of the
American College of Gastroenterology; Oct 15, 2003; [link]
— Association of Colonoscopy and Death From
Colorectal Cancer; N. N. Baxter, M. A. Goldwasser, L. F. Paszat, R.
Saskin, D. R. Urbach and L. Rabeneck; Ann Intern Med 2009; 1-8; [link]
— Screening and Surveillance for the Early Detection
of Colorectal Cancer and Adenomatous Polyps, 2008: A Joint Guideline
from the American Cancer Society, the US Multi-Society Task Force on
Colorectal Cancer, and the American College of Radiology; Levin,
Bernard, at al; CA Cancer J Clin 2008 58: 130-160; [link]
— The Effect of Fecal Occult-Blood Screening on the
Incidence of Colorectal Cancer; Mandel, Jack S., Church, Timothy R.,
Bond, John H., Ederer, Fred, Geisser, Mindy S., Mongin, Steven J.,
Snover, Dale C., Schuman, Leonard M.; N Engl J Med 2000 343: 1603-1607;
— Population-based surveillance by colonoscopy:
effect on the incidence of colorectal cancer. Telemark Polyp Study I.;
Thiis-Evensen E, Hoff GS, Sauar J, Langmark F, Majak BM, Vatn MH.; Scand
J Gastroenterol. 1999 Apr;34(4):414-20; [link]
— Colorectal Cancer Risk Assessment Tool; National
Cancer Institute; [link]