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Colonoscopy 'Potentially Inappropriate' for 30% of Seniors

Cheryl Clark, for HealthLeaders Media, March 12, 2013

Discontinuation would mean a much more difficult and significant decision they would have to make.

And they were skeptical of recommendations that they should not have screening, saying it would threaten their trust in their doctors and make them suspicious that a guideline they shouldn't be screened was made only to save money.

"Public health education and physician endorsements (of cancer screening) may have created a high degree of 'momentum' for continuation screening, even in situations in which the benefits may no longer outweigh the risks or burdens."

In an invited commentary, Mara Schonberg, MD, MPH, of Harvard Medical School and Beth Israel Deaconess Medical Center in Boston, noted that as much as colonoscopies are celebrated as a preventive therapy, they also cause harm.

"Harms of cancer screening are immediate and include pain and anxiety related to the screening test, complications…(e.g., bowel perforation from colonoscopy,) or additional tests after a false positive result, and overdiagnosis (finding tumors that would never cause symptoms in an older adult's lifetime). Overdiagnosis is particularly concerning because some older adults experience significant complications from cancer treatment."

She blames "unbalanced public health messages" for contributing to "perceptions that cancer screening should be continued indefinitely," she also points to the physician's recommendation as a strong driver of whether a senior citizen undergoes one.


Cheryl Clark is senior quality editor and California correspondent for HealthLeaders Media. She is a member of the Association of Health Care Journalists.
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1 comments on "Colonoscopy 'Potentially Inappropriate' for 30% of Seniors"


mkparker1210 (3/12/2013 at 4:23 PM)
One of the things that's missing from harm from colonoscopies is the preparation. Studies have shown that the kidneys take a hit and geriatric patients could be at risk for electrolyte imbalances related to the prep. This can also place the patient at increased risk for falls.