Johns Hopkins Health Alert
Questioning Colonoscopy for the Very Elderly
Is there an age beyond which it doesn't make sense to have a colonoscopy anymore? Research suggests the risk of colonoscopy may outweigh the benefits in octogenarians. Johns Hopkins explores the research.
So far, there is no recommended cut-off age for a colonoscopy or for Medicare reimbursement. But as the number of Medicare recipients grows, along with the number of elderly people having regular colonoscopies, researchers are taking a look at the costs as well as the risks and benefits of colonoscopy in older people.
Two recent studies reviewed the results of more than 3,000 colonoscopy tests to address the question of when people might stop having these procedures. While the risks of developing colon cancer increase with age, the researchers observed, life expectancy decreases after age 80. Because colon cancers are slow to develop, and cancer rarely develops within 10 years of a negative colonoscopy, people over age 80 are likely to die of other causes even if colon cancer begins to develop.
In fact, the same German study that investigated the risks of a 20-year interval between colonoscopy tests also found that people who had a negative colonoscopy after age 55 probably have a very low risk for the rest of their lives. And in one study that reviewed colon exams in people age 50 and up, screening people who were at least the age of 80 only resulted in a 15% gain in life expectancy when compared with the benefit seen in the younger participants who were screened.
While a colonoscopy is safe for the elderly, it is never pleasant -- even for the young -- and research indicates that elderly people are less likely to cleanse their bowels adequately and are more likely to experience incomplete exams and complications. Putting all of these findings together, researchers suggest that doctors carefully consider the indications for colonoscopy in people who are over age 80. The colonoscopy may not be needed or appropriate for everyone.
Posted in Colon Cancer on December 9, 2008
Reviewed September 2011
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