Welcome back to Plenary Session podcast. This is a sensible medicine exclusive. I'm joined by two of my friends and colleagues. Dr. Adam Seifu, Professor of Medicine University of Chicago. He's a practicing internist, and as you'll learn soon, he is a GI doctor apologist. And Dr. John Mandrola, who is a practicing cardiologist and a great student of evidence-based medicine.

And you know me, but I preside oncologist, professor of epidemiology.

We're going to be talking about the Nordic study, a randomized controlled trial of colonoscopy,

the very first one.

This is going to be a discussion, a debate.

We don't all see eye to eye.

We're going to get into the weeds.

But first, I want to thank you both for joining me and maybe see if you have a debate we don't all see eye to eye we're going to get into the weeds but first I

want to thank you both for for joining me and maybe see if you have any opening

thoughts Adam thank you for joining us sure my opening thoughts are I think both

you guys are wrong so this is your chance to set us straight. And John, any opening thoughts?

Thanks for having me. And I guess my opening thought is that I want to say that the reason why a

cardiologist is involved in the GI screening paper is twofold. One, I get about five messages per day asking if my AFID patients can DC their anti-coagulants

for colonoscopy.

Number two, I think that if nothing else, this trial is a good exercise in thinking and

critical appraisal, and that's one of the reasons why

I'm so interested in it. And that's well put. So I wanted to start by just getting us all to

agree on the facts and then we'll get into this study and we'll talk about interpretation and what

it means. So here's the way I think of the lay of the land when it comes to colorectal cancer

screening. All screening tests, the purpose of the screening test it comes to colorectal cancer screening. All screening tests,

the purpose of the screening test, is to find cancer before it becomes advanced. And you find it at a stage where you can act upon it, presumably that if you had let it go unchecked, it would

get to a stage where it's less likely to be amenable to therapy. And the moment you get to a point

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