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Repeat Colonoscopies: Expensive, Unnecessary, and Harmful


Posted on Jun 04, 2011

Colonoscopies are examinations that search for polyps, or growths, which can eventually become colon cancer. The medical community believes these examinations are necessary, particularly for those over 50 years of age, because colon cancer is easily treatable in its early stages. The procedure is underused at 50, but elderly patients overuse it.

The acknowledged rule for colonoscopies is to have them once every ten years. But in a study published this May in The Archives of Internal Medicine, the University of Texas Medical Branch noted that of 24,000 negative colonoscopy results among Medicare enrollees, 46% of them returned for another exam within seven years; many returned between three and five years later. Almost a quarter of these early repeats did not provide a reason for the added test.

Furthermore, although the US Preventive Services Task Force recommends against colonoscopies for those over 75, one-third of those over 80 had a colonoscopy within seven years. The head researcher, Dr. James Goodwin, saw this as a "truly mindless application of guidelines that were developed for 50-year-olds.”

The physical toll of the procedure for older patients could be high and could lead to disrupted eating and sleep, as well as the need for further medication. Dr. Goodwin warns: “It would be a very bad idea for people with moderate dementia,” which includes many patients over 85.

He admits that the rate of complications are low, but "if you double the rate of screening, you double the complications and deaths, without any benefit to patients.”

Repeat colonoscopies become an even greater nuisance when one factors the cost of $1000 per exam for Medicare to shoulder.

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