Too frequent colonoscopies in older folks

Related articles

A significant number of folks over age 70 may be getting unnecessary colonoscopies, according to a study published in JAMA. The U.S. Preventive Services Task Force recommends colorectal cancer (CRC) screening begin at age 50 for those at average CRC risk, and follow-up studies every 10 years until age 75. The rationale behind these guidelines is that colon cancer commonly progresses very slowly; therefore, early detection is unlikely to benefit older adults.

Researchers looked at data on 75,000 colonoscopies performed in adults 70 and over in Texas between October 2008 and September 2009. They found that 23.4 percent of those colonoscopies performed were inappropriate based on the USPSTF recommendations and previous colonoscopy results. Those patients are being exposed to unnecessary risks of the procedure, including perforation of the intestine and bleeding, although such complications are highly uncommon. Also, excessive testing is a waste of money and increases the chances of finding false positive results, requiring still more testing.

Study researcher Kristin Sheffield, an assistant professor of surgery at the University of Texas Medical Branch, says, We hope that there will be efforts to align screening practices with current guidelines, perhaps through better communication between doctors and public education campaigns to correct misperceptions.

And ACSH s Dr. Elizabeth Whelan comments that this is just one of many procedures that seems to be overused in older populations. She also adds though, that there will be a lot of resistance by patients to changing their routine if they have been undergoing colonoscopy more often than recommended.

ACSH s Dr. Gilbert Ross wanted to emphasize another point of view: Without quibbling with this study s findings, let s not forget that colonoscopy is an excellent screening test for detecting early CRC, and it is under-utilized: many people who should have the test are skipping it, putting themselves at risk.