You're supposed to have your first colonoscopy at age 50, and then every 10 years after, unless the test finds polyps or you have a family history of colon cancer.
Medicare now pays for colorectal cancer screening which means more seniors are having a colonoscopy. But is there ever a point where it's time to stop? When the inconvenience of the unpleasant preparation and the slight risk of complications from this invasive medical procedure - which are higher for very elderly patients - outweigh the benefits? Current guidelines don't have a cut-off age.
A study out Tuesday asked that question: Does there come a point when having a screening colonoscopy doesn't do much to extend your life? The study, published in the Journal of the American Medical Association was done here in Seattle, by doctors at Virginia Mason Medical Center.
While the incidence of colon cancer and colon polyps does increase with age, Dr. Otto Lin found that a screening colonoscopy in very elderly patients - those who are 80 or older - may be "smaller than what is commonly believed."
"Sometimes in very elderly patients, they may die from natural causes before the polyp has a chance to become cancer," Dr. Lin told me.
"We're not saying you should not have a screening colonoscopy, but we are saying that the benefits might be much smaller than for people who are younger and it should be an individual decision between a patient and his or her physician."
What seniors in their 70's and 80's should really do, Dr. Lin says, is "talk to your doctor in detail before going forward with the colonoscopy." You need to weigh the risks vs. the benefits, based on your medical history.
NOTE: While the American Cancer Society recommends that men and women start testing for colon cancer at the age 50, they advise talking to you doctor about starting screening earlier and/or undergoing screening more often if you have any of the following colorectal cancer risk factors:
- a personal history of colorectal cancer or adenomatous polyps
- a strong family history of colorectal cancer or polyps (cancer or polyps in a first-degree relative [parent, sibling, or child] younger than 60 or in 2 first-degree relatives of any age)
- a personal history of chronic inflammatory bowel disease
- a family history of an hereditary colorectal cancer syndrome (familial adenomatous polyposis or hereditary non-polyposis colon cancer)
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