Many seniors get colon screening too often

CHICAGO - many older Americans get colon cancer test repeat that they do not need and Medicare is paying, suggests a study which highlights unnecessary risks for the elderly and a waste of money.

Nearly half of patients Medicare in the study had a colonoscopy less than seven years after obtaining normal results from a previous test. The test is recommended only once every 10 years, starting at the age of 50, for people at average risk including test initial is normal.

The study showed that among the 80 and more, a third had a review repeated within seven years of previous colonoscopy. This is an age group that can take the test if any problems have been identified before.

The U.S. Preventive Services Task Force recommends against colon cancer screening routine for most of the 76 to 85 people - and said to those aged more 85, screening risks prevail on benefits.

The more you are, you are more likely to die of other causes before the cancer becomes lethal, which means that the risks of the procedure of control can prevail on its advantages in many older patients, the authors of the study said.

"I was surprised by the magnitude of the issue," said lead author Dr. James Goodwin, a geriatrician and researcher at the University of Texas Medical Branch at Galveston.

In the study, researchers selected a random sample of national health insurance claims and the data of registration more than 200,000 patients 65 years who received colonoscopies between 2001 and 2008. The number of patients in the sample totaled 24,071 - all persons considered as normal risk of colon cancer.

The results suggest most repeated examinations are unnecessary; only 27 percent of all patients in study with frequent reviews had symptoms which could raise the suspicion of cancer, including abdominal pain, changes in bowel habits and weight loss. The study appears in the Archives of internal medicine, Monday.

Colonoscopy is considered as one of the more effective screening tests available, and he is credited for saving thousands of lives by catching cancer early. The physician uses a thin flexible tube to examine the intestines. It can cut off the coast of suspicious growths to research.

The examination is generally quite safe, but a risk that occur more often with older patients, including complications of sedation, accidental perforation of the colon and bleeding.

Medicare covers colonoscopy every 10 years - more frequently in patients at high risk, including those with a family history of colon cancer. But in this study, the authors have excluded patients at high risk.

Fresh colonoscopy vary considerably, but exceed generally $ 1,000. While Medicare rules say that the Government will not pay too frequent colonoscopies, only 2% of the study claims were denied for examinations repeated in people without symptoms.

The results suggest regulation of insurance "does not work", said Goodwin.

Excessive colonoscopies are not only economically expensive, he said, noting that they can constitute actual damage for patients, especially the oldest.

Robert Smith, Director of the screening at the American Cancer Society, said that some doctors may recommend more frequent colonoscopies because they believe in 10 year intervals are too risky. Some may think, wrongly, that find all grand cru, even non-suspicious polyps, means a repeat examination should be made within 10 years, Smith said.

Some doctors also order repeats tests "because they want to bring in income", he said.

Be risky and expensive, too frequent projections make colonoscopy resources less available for people who really need, Smith said.

But, he noted, while colonoscopies may be overuse in the elderly, examinations and other methods of screening for cancer of the colon are underutilized among some groups, including the uninsured, blacks and Hispanics.

Centers for Medicaid & Medicare Services Government issued a statement in response to the study, saying that the Agency recognizes the importance of effective screening as well as "the importance of ensuring the beneficiaries of Medicare only obtain projected at appropriate intervals.".

Medicare covers examinations every two years for patients at high risk, but if the results of the study are true, "then we should further validate the accuracy of our payments", said the spokesman for the Agency Ellen Griffith.