, Volume 28, Issue 1, pp 6-8
Date: 28 Sep 2012

Too Much of a Good Thing: Cancer Screening in the Old and Infirm

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It is recruiting season for Gastroenterology Fellowship programs. In reading their personal statements, I have noted that prospective applicants often highlight one of the major draws of our subspecialty—treating life-threatening emergencies. Massive hematemesis and obstructing volvulus are high-stakes and high-reward opportunities that can raise the catecholamine level of even the most seasoned endoscopist. Success in such cases provides an extremely high level of satisfaction. While failure or even endoscopic complication in these cases is disappointing, the result is that the patient undergoes surgery that they likely would have needed if the endoscopy had not been attempted. That is why my heart rate and blood pressure are never higher than when a routine screening colonoscopy appears headed to complication. While thankfully rare, the thought of subjecting an individual without prior symptoms or problems to a hospitalization or surgery is extremely distressing. So, taken from that

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