I just finished reading Too Many Colonoscopies for the Elderly, a short article that appeared on the New Old Age blog at the New York Times. The March 12, 2013 post, by New Old Age journalist and editor Paula Span, explains how the United States Preventive Task Force recommends that routine screening colonoscopies not be performed on people older than age 75. It brought back some dramatic memories for my husband and me.
A few years ago we helped my husband’s 89-year-old mother go through the colonoscopy preparations and the procedure itself. She was exceedingly healthy and still six months away from a serious stroke.
Spending a day on liquids was difficult for the small woman — she was dizzy during the entire day and exceedingly so by the evening. Then she proceeded with the preparation, drinking the gallon of liquid and going through the various stages of diarrhea. Added to the dizziness was nausea, and she felt worse and worse. Despite her uncomplaining nature, getting through the final hours and procedure was a huge challenge.
Although there were no serious complications once the colonoscopy was over, my husband’s mother spent the next several days feeling poorly, and she really did not feel up to her old energy level for nearly a week.
Even though there is an increasing body of evidence that suggests that people over 75 should think carefully about going through the arduous process of a screening colonoscopy, many physicians still perform them on aging seniors. A lot of elders who I know are still going through the exhausting and sometimes debilitating preparation process and then the procedure.
Check out this Journal of the American Medical Association (JAMA) article, Overuse of Screening Colonoscopy in the Medicare Population. It notes that a significant number of older seniors get screening colonoscopies more often than the recommended 10-year interval. This article is available without charge. Another freely available journal article was published in the Journal of General Internal Medicine. In Assessing the Impact of Screening Colonoscopy on Mortality in the Medicare Population, researchers explain how they accessed National Cancer Institute data on individuals between 67 and 94 years old and found that the benefits of screening colonoscopies were substantially lower when patients had other chronic health conditions.
Paula Span has also written another New Old Age post about the problem of unnecessary tests in another blog piece, Unnecessary Color Screenings for Elderly Patients. A good and readable explanation about aging patients and colonoscopies is posted at the Johns Hopkins Medical Center Health Alerts Site. A U.S. News Health report via Health Day also gives a good overview of how elders can weigh the risks and the benefits of routine colonoscopy screenings.
Whether or not an elder parent decides to go through with a colonoscopy, it’s good to know as much as possible about the usefulness of the procedure, especially as people age and they develop other chronic medical problems such as high blood pressure and heart conditions such as atrial fibrillation.
We need to share this information with our parents now, before a physician suggests a screening colonoscopy, so that they can make an informed decision about going through with the test.