Reason #73 That No One Wants a Colonoscopy

Imagine you are 17 years old again and applying to college. You have your heart set on Stanford, but know it’s a long shot. Your well-meaning aunt, aware of your interest in that fine Palo Alto institution, buys you a Stanford sweatshirt.

Would you wear it before you found out whether you had been accepted?

I know I wouldn’t. For starters, it would look a bit presumptuous for my tastes. But in addition, wearing the sweatshirt would make me feel like I was tempting fate – like it would jinx my chances of getting in.

I know I’m not alone in having these feelings. Many of us are prone to this kind of mystical fatalism. The envelope is already in the mail, carrying either good or bad news, and yet somehow the very act of wearing that sweatshirt will cause the news to be bad.

George Costanza expressed this kind of mystical fatalism in a Seinfeld episode, during which he was obsessing about a white discoloration over his lip. Jerry was trying to convince him to see a doctor, but George refused: “I’m not going to the doctor. If I don’t go to the doctor, then nothing will happen to me. If I go, he might find something.”

I cannot tell you how many times in my career I’ve taken care of patients who’ve waited – too long – to come see me, or to undergo the colonoscopy that I had recommended to them, out of fear that I would “find something”.

Now admittedly in some cases this kind of thinking isn’t so mystical after all. If a 40 year old woman doesn’t go looking for breast cancer, her doctor won’t find that pseudo-cancerous ductal carcinoma in situ (DCIS) lesion, one that many experts believe many women would be better of leaving alone, but that, nevertheless, prompt many women to have aggressive and invasive treatment. We medical types keep revising the definition of disease, to the point where if we look hard enough, we will find something wrong with almost everybody.

In the case of colon cancer, however, this kind of magical thinking is life threatening. With colon cancer, you see, screening tests save lives at very low risk of harm. Right now, my 50-year old body may or may not be harboring precancerous growths and polyps. If detected early, these polyps can be removed before they pose any danger to my health. Looking for these polyps doesn’t – repeat doesn’t! – increase the chance that I have been visited by these invaders.

That means I need to put on a sweatshirt and get down to the gastroenterology clinic and have a colonoscopy or a flexible sigmoidoscopy, or even get a fecal occult blood test from my primary care physician.

Color cancer screening saves lives.

**Previously posted on Forbes**