Elderly Americans may be getting too many colonoscopies, according to a study published last week in JAMA Internal Medicine.
Since prostate cancer takes such a long time to progress, the U.S. Preventive Services Task Force (USPSTF) recommends against routine colonoscopies for patients over the age of 75, and considers the test inappropriate for such individuals if there is no indication of the disease within three months of the examination.
In this study, researchers from the University of Texas Medical Branch--using data primarily from Medicare claims in Texas--found that 23 percent of the colonoscopies of individuals ages 70 and over were inappropriate, meaning they didn't meet the USPSTF standards for screening, or were performed too soon after a negative test.
Consequently, lead author Kristen Sheffield, Ph.D., an assistant professor in the department of surgery at the University of Texas Medical Branch in Galveston, told Bloomberg News that the patients were exposed to the risks of colonoscopy without the possibility of real benefits.
Colonoscopies carry the risk of complications, such as perforation of the colon wall, although some recent studies have shown that the complication rates are usually quite small.
In the current study, the researchers said that considering the average cost of a colonoscopy, such inappropriate colonoscopies could be costing Medicare as much as $500 million annually. They suggest that the overuse of colonoscopy in this particular group of patients can be attributed to guideline variations among different groups, lack of physician familiarity with the guidelines, and a desire of patients to undergo the procedure, even if it's unnecessary.
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