Meds and colon screening

[MichaelJ]

I recently took an at home test for a colon screen which came back positive and abnormal since they found blood in the sample (not sure the amount). Since I am 9 months post surgery from a medical valve replacement and currently on Coumadin, I was curious if any of you experienced this or knew if blood thinners could be a cause.

I realize this isn’t a pleasant post but you all know so much on this forum.

I do plan to get a colonoscopy very soon as I am 59.

Thanks.

 

[Chuck C]

I'm on warfarin and did a Cologuard about a year ago. It came back negative- no blood no abnormal cells.

I'm not sure if the positive has you worried, but you should be aware that the vast majority of colon screens that come back positive end up not being cancer. My wife had a positive about 3 years ago, which led to a colonoscopy. One small benign polyp.

 

[MichaelJ]

I'm on warfarin and did a Cologuard about a year ago. It came back negative- no blood no abnormal cells.

I'm not sure if the positive has you worried, but you should be aware that the vast majority of colon screens that come back positive end up not being cancer. My wife had a positive about 3 years ago, which led to a colonoscopy. One small benign polyp.

Thanks for the response Chuck.

 

[pellicle]

I'm also on warfarin and have done that test as well, it came back negative. I've also had a colonoscopy and if you are going down that tube you may wish to read these blog posts

Perioperative Management of INR

Eventually one finds that some sort of small surgery is needed, for those of us on warfarin (perhaps after a large surgery such as a heart v...

cjeastwd.blogspot.com

rapid dust off perioperative INR management

A post on the management of Anti Coagulation Therapy (ACT) by Vitamin K Antagonist (VKA) - Warfarin I've decided to call this the rapid Du...

cjeastwd.blogspot.com

However there are false positives with that particular test. Given my personal experience I wanted to try the screening, and I found this interesting and it guided my next assessment

Don’t order colonoscopy as a screening test for bowel cancer in people at average or slightly above average risk. Use faecal occult blood screening instead.

www.choosingwisely.org.au

The Royal Australian College of General Practitioners​

Recommendations from the Royal Australian College of General Practitioners (RACGP) on treating hypertension or hyperlipidaemia, prescribing benzodiazepines, self-monitoring of blood glucose, proton pump inhibitor therapy and screening for vascular disease. The Royal Australian College of General Practitioners (RACGP) is Australia’s largest professional general practice organisation and represents urban and rural general practitioners. We represent more than 30,000 members working in or towards a career in general practice. There are more than 125 million general practice consultations taking place annually in Australia.

RACGP guidelines recommend two-yearly faecal occult blood testing (FOBT) from 50-75 years of age. The best available data to 2011 suggests 13% of this group were instead over-screened using colonoscopy.
National Bowel Cancer Screening Program (NBCSP) data shows that, per 10,000 people in this group followed up for an average 18 months, 6 will die from bowel cancer if unscreened. If screened with colonoscopy, 2.3 will die (1.5 from bowel cancer plus 0.8 from colonoscopy complications), compared to just 1.9 deaths for FOBT. A colonoscopy also risks bowel perforation (7 per 10,000), involves bowel preparation, and costs around $3000. NBCSP monitoring shows that a negative FOBT is 99.9% specific in ruling out bowel cancer.
Recommendation released March 2016

Supporting evidence​

• RACGP, Red Book Taskforce. Guidelines for preventive activities in general practice. Royal Australian College of General Practitioners: Melbourne (2012). Available from: RACGP - Colorectal cancer
• Ouakrim DA et al. Screening practices of Australian men and women categorized as ‘‘at or slightly above average risk’’ of colorectal cancer. Cancer Causes Control 2012;23:1853–1864. (The 13% figure taken from the latest, unpublished data, received via correspondence from the primary author, Oct 2015).
• Emery J. NHMRC Centre for Research Excellence for Optimising Colorectal Cancer Screening at the University of Melbourne. AIHW data, National Bowel Cancer Screening Program.
• Viiala CH, et al. Complication rates of colonoscopy in an Australian teaching hospital environment. Internal Medicine Journal 2003;33:355-9.
• Australian Institute of Health and Welfare. Analysis of bowel cancer outcomes for the National Bowel Cancer Screening Program. 2014 Canberra: AIHW cat. no. CAN 87. Available from: http

 

[pellicle]

Oh, one last thing ... do you have any blood ever when you wipe?

 

[Martin1962]

Last year I had an abnormal colon home test result a couple of months after my mitral valve was replaced with mechanical in Jan 2022 when I was 59. This is in the UK. My cardiologist didn't want me coming off warfarin for a colonoscopy so soon after surgery unless I really needed to, so they did a "virtual" colonoscopy instead using a CT scan. This revealed a benign polyp which was removed via a full colonoscopy a few months later in November and did require me coming off wafarin and bridging with injections. The CT scan also showed a kidney stone (no symptons, luckily). This was removed in February this year, again requiring me to come off warfarin and bridge with injections. All went well, just waiting for the next thing needing a procedure / bridging!

 

[MichaelJ]

Thanks Pellicle,
Interesting articles and yes I had a bit of dried blood on my tp about a week ago but nothing since. When I first heard about the blood in the sample, it really scared me for a couple days but now i have chilled out a little as i feel great, eat like a horse and kept my weight where it should be. Now I am just waiting to see the Dr.

I appreciate the reply Martin,
After reading your response, it will be interesting what my Dr/Cardiologist tells me how to go about this. The funny thing is I was notified of my abnormal results on Friday 5am via automated email and told someone would get ahold of me shortly.
It’s Monday night now where I’m at and I haven’t heard anything. I’ll be calling in a couple days if I still don’t get a call.

Again thank you both, hoping for the best.

 

[pellicle]

yes I had a bit of dried blood on my tp about a week ago but nothing since.

the test is quite sensitive and blunt as to where the blood came from.

If one has any haemorrhoids that flare up now and then then do not do the test while they are active. I can suggest other things but you may wish to PM me for that (because even I have levels of discussion I avoid in public ;-)

Happy To Help (my version of HTH)