Colonoscopy – What ages are most appropriate for screening and who are the best candidates. The NY Times weighs in.

Colonoscopy – What ages are most appropriate for screening and who are the best candidates. The NY Times weighs in.

If you are in our age group (50 ish), chances are you have had a colonoscopy or are considering having one. These are currently the best way of screening for possible cancerous grows in the colon (polyps, etc) that we currently have available. The current recommendations are for us to have this done around the age of 50 and about every 10 years. Since this does require you to be put under anesthesia, it is not a simple screen. While there has been research on other methods such as pill type camera’s, currently colonoscopy is the gold standard for screening the colon.

Important tip: When it comes to insurance, the new Obama care law states that this is a covered screening at 100 percent. While this should be true for an expensive procedure like this, be aware that insurance companies may have their own way of interpreting the law and if your plan is self insured, it may also have its own way of interpreting this as well. Please check your coverages with your insurance company and your doctor. While this is a preventative screening, if you ever had a screening where something was found, even if it was benign, it could cost you and fall under your hospitalization deductible instead (learned from personal experience).

There are now recommendations as noted in the NY Times health section that are suggesting that screenings be limited on those above 75 years of age and be avoided in those over 85. Since this is a preventative procedure that can add years to your life if a problem is found early, those in their late 70’s and 80’s are more at risk from the procedure itself (fasting, anesthesia). The question also arises that if you found something, as is more common in someone in their older years, does the risk of intervention outweigh the benefits of leaving them alone. Perhaps, this is where this current discussion came from and it makes sense, since those who are older are often talked into having things done medically that offer little benefit, are expensive and can shorten their lives so the procedure is more detrimental vs. beneficial at that time of life.

Read the NY Times article here

Too Many Colonoscopies in the Elderly

By PAULA SPAN

Bill Fullington doesn’t remember exactly where he read that all adults over age 50 should be screened for colon cancer. A magazine? Maybe the local paper?

In any case, Mr. Fullington, a retired teacher in Birmingham, Ala., takes excellent care of his health; he never smoked, doesn’t drink, hits the gym daily. “Everybody thinks I’m 30 years younger than I am, because of my zip,” Mr. Fullington said in an interview. So he dutifully arranged to have a colonoscopy in 2008, when he was 80.

The doctor removed two small polyps — “the size of BBs,” Mr. Fullington said — and sent him home to recover. The next day, “I woke up screaming in pain.”

At the emergency room at Brookwood Medical Center, tests showed that the procedure had perforated his colon. Mr. Fullington underwent a colostomy and spent a week in intensive care — and that was just the beginning.

March is Colorectal Cancer Awareness Month, so you may be reading and hearing a lot about the importance of screening. You may even get to walk through the eight-foot-high inflatable simulated colon that makes appearances around the country — and see what polyps look like from the inside. But you may not hear much about when colon cancer screening should stop.

Even the Fight Colorectal Cancer Web site, from the major advocacy group working to make Americans aware of the disease and its prevention, says that all adults over age 50 should be screened. “Don’t wait. Talk to your doctor,” it urges.

But in 2008, just a few months after Mr. Fullington’s colonoscopy, the United States Preventive Services Task Force reviewed years of research andrecommended against routine screening for colorectal cancer in adults over age 75 and against any screening in those over 85.

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