Steve, Sandy has the option, as a health system employee, to go the CT route rather than get scoped. I have no idea what her cost would be. Also, if your first colonoscopy is negative, your follow-up procedure interval changes to every ten years, rather than 5, or annually if you have verified direct family history risk.
I fully agree with the don't neglect a suspicious skin lesion recommendation. I had just finished the North American VASA ski race in Traverse City. While toweling off after showering I noticed blood on the towel and found a medium nearly round dark mole on the underside of my right bicep as the source, about the size of a pencil eraser. I had a physical coming up the following week, so a waited. I pointed it out during the physical. I distinctly remember my internist saying, "It doesn't look like melanoma that I have seen, but it doesn't look "right"." He called upstairs to one of the dermatologists who said he would see me during lunch. Less than a minute after looking at it he told me it was melanoma, likely nodular melanoma, which is often round without the "oil-slick" skin discoloration around the margin. When I asked about how significant nodular melanoma was among the group, he informed me it was one of the rapidly invasive types of melanomas, occurring in about 15% of diagnoses. I had my surgery, opting for wide margins and removal of everything down to my bicep, but not opting for tracer dye injection to determine lymph drainage pattern to guide removal of my sentinel node, since the false positive rate for this was still quite high. Since my experience, they have changed to a new tracer dye. I did opt for immunoglobulin injections, but only made it half way through the interval, due to side effects. New immunotherapy drugs focus on PR-1 TCLA-4 receptor signaling suppression in tumor cells, and are far more effective, with cleaner SE profiles.
When I was at U of M's melanoma clinic I asked them why the epidemiologic data on melanoma indicates it is increasing in the US population, despite our shifting demographics away from being an agrarian society. Their answer? We are taking our kids out in the sun at earlier ages for lengthy exposure intervals. Per their data, severe burns before age five are the greatest predictor of future melanoma risk.
