Colonoscopy after 75 may not be worth it : Study
A colonoscopy can find and remove cancerous growths in the colon, but it may not provide much cancer prevention benefit after the age of 75, a new study suggests.
A review of more than 1.3 million Medicare patients aged 70 to 79 found that having a colonoscopy reduced colon cancer risk slightly over eight years, from just under 3 percent to a little more than 2 percent in those younger than 75. But it had little or no effect on cancer risk among patients over 75.
However, Robert Smith, vice president for cancer screening at the American Cancer Society, said it would be misguided to stop all colonoscopies for people once they turn 75. The better criterion is the overall health and life expectancy of the patient, he said.
The issue is with older adults whether or not there is any benefit for screening. After 75, you can make individualized decisions [about] whether screening is appropriate, said Smith, who was not involved in the study.
Screening guidelines from the U.S. Preventive Services Task Force recommend screening for colon cancer with any method, including colonoscopy, from age 50 to 75. Medicare reimburses colonoscopy, regardless of age.
Smith said the people in this study were in good health. But, in practice, people with limited life expectancy are also being screened, which is not recommended, he said.
Study lead author Dr. Xabier Garcia-Albeniz, a research associate at the Harvard School of Public Health, and colleagues noted that colonoscopy is an invasive procedure that requires a thorough bowel cleansing and often sedation beforehand. Risks of complications include bowel perforation during the procedure. However, the study authors found that the risk for serious harm from colonoscopy was small in both age groups.
Patients, physicians and policymakers may want to consider these findings when making decisions about colorectal cancer screening, especially in upper age groups, the researchers said.
HealthDay
