Petite Peek
My friend Sami was considering a virtual colonoscopy instead of opting for the more traditional approach. The typical procedure is rarely anything folks look forward to happily. Anyone who does so might like to add mental health counseling to their regimen. In other words, almost everyone approaches this as a necessity, but with a decided yuck-factor.
Refer to my post Lions, Tigers & Colon Screening, Oh My – Options and Alternatives about colon-health evaluations. Yet, what about the question of having any procedure at all? Since Medicare for those over 65 reimburses for screenings, it often seems a ‘no-brainer.’
National guidelines support screening for colon cancer for anyone age 50-75. Ok, so what about those over 75?
A 2019 Harvard study reviewed an impressive number of more than 1.3 million Medicare patients aged 70-79. Their findings showed that for those over 75, a colonoscopy had little or no effect on cancer risk, meaning there was not a cancer-prevention benefit. Surprisingly (to me), researchers found little more than 2% colon cancer reduction for those patients 50-75 who were followed for 8 years after a colonoscopy.
Risks after Colonoscopy for those of a Certain Age
The medical profession, as yet, has no well-established age guidelines that determine when to stop colon screenings. Further, recent findings generate a more difficult struggle to determine recommendations, because emergency department visits and hospitalizations show an increase for those 75 and older following the procedure.
One study analyzed over 27,000 patients (for a total of 30,409 colonoscopies and for appropriately equal number of men and women). The tests were performed by 40 different practitioners. Accounting for independent variables, and compared to those of similar age, results for those over 75 were unnerving. Within the 7 days following the outpatient colonoscopy, the patients were:
- 1.6 times more likely to use the Emergency Department
- 3.7 times more likely to be hospitalized
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The American Cancer Society maintains that the decision to continue with colonoscopy schedules when over age 75 should depend on the overall health of an individual.
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TIP. As a compromise between virtual and traditional tests, I might suggest the option of non-invasive, but still effective, products like Cologuard (or similar). Explained here, they might be the choice for those over 75. It removes the preparation and discomfort of a traditional colonoscopy but continues to provide equally valuable information for diagnostic purposes.
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FINAL THOUGHT
“Most Scholars have gotten very critical of the things
that are done to us in the name of health care…
When you look at what those procedures are based on,
you begin to see that a lot of them aren’t evidence-based.
They’re rituals doctors perform to reassure their patients.”Barbara Ehrenreich – from interview with author of
Natural Causes: an Epidemic of Wellness, the Certainty of Dying
and Killing Ourselves to Live Longer.
Despite Ehrenreich’s explanation that doctor’s perform certain ‘rituals’ as assurance to patients, it doesn’t always work.
For me at least, I am not reassured.
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Reference:
Colonoscopy benefits after 75 Questioned: https://www.hsph.harvard.edu/news/hsph-in-the-news/colonoscopy-benefits-questioned/
Patients over Age 75 Are at Increased Risk of Emergency Department Visit and Hospitalization Following Colonoscopy. Patients over Age 75 Are at Increased Risk of Emergency Department Visit and Hospitalization Following Colonoscopy | SpringerLink
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Picture credits Colon and magnifier _Colonoscopy by Giorno Brando public domain CC0 1.0
Surprise colonoscopy: invasive medical procedure by wotthe7734 is licensed under CC BY 2.0
