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Did you see the Part I of this lecture? To me the sigmoidoscopy/colonoscopy issue comes down to this
fundamental question of the individual’s health versus the public health. Something I
tell my patients all the time when I’m about to do their colonoscopy is that you have a
one in a thousand chance of having a perforation, but remember, if it’s you, it’s
100%. And of course if you’re the one that’s not okay, you’re not very happy about
that. So we really have a lot of issues in terms of defining the level of risk a society
or an individual can tolerate in terms of proceeding forward with screening. Obviously, a
population-based approach needs to account for the safety of the procedure, the cost of
the procedure, availability, and a lot of issues like that. |