Dr. J: In two recent studies in The New England Journal of Medicine, results were reported about the use of CT scans in screening for colon cancer, and about how long we should wait between colonoscopies to screen again. Is this new info?

Dr. R: Not really, virtual colonoscopy or CT colonoscopy can be a very good study. If someone is averse to having a regular colonoscopy or can’t afford a regular colonoscopy (virtual is cheaper), it can be a valuable screening tool. There are a couple of things to keep in mind. First, the test is only as good as the radiologist who reads it. It takes experience to read them correctly and there is a learning curve. Secondly, if something is found, the patient will need a colonoscopy for biopsy and treatment and the whole prep has to be done all over again. Finally, virtual colonoscopy is good for picking up large lesions that stick out but may not be as good for lesions that are flat. I think that having the CT colonoscopy every 5 years is a reasonable interval for that reason and until we have a large group of radiologists experienced in reading the studies. Colonoscopy is still the gold standard evaluation for now. But, virtual colonoscopy is a good option for some.

Now one for you. What’s this I read about the fact that more people have HIV in the US than anyone thought. Were the numbers wrong before? Can’t they count??!! Do we need to be worried?

Dr. J: Not to worry. First of all, the figures released by the Centers for Disease Control and Prevention have never been based on actually counting the number of people who have HIV. Why is this? Quite simply, we don’t know how many people in this country actually have the infection because it is not mandatory in many states for patients or their doctors to report that they have the infection. So, the numbers have always been estimated by very complex methods. This time was no different, though the method of calculation was newer. Even the Director of the CDC admitted that she found the method used to calculated the estimated number of people with HIV extremely complicated. So, despite what the lay press reported, the number of people with HIV is not on the rise.

However, these numbers do indicate that the transmission of HIV has not decreased much in the past ten years, which also means that prevention efforts in some communities have not been successful.

So, yes, we need to be still be concerned about this sexually transmitted infection – even at our age – but not panicked. We address this issue at length in Chapter 6 of our book.

Dr. R: Whew! Can we take a break now?

Dr. J: Absolutely. To our readers: enjoy your week and don’t forget to make taking care of yourself a priority!