Many Colonoscopies for Older Adults May be Inappropriate

A
study by Kristin M. Sheffield, Ph.D., and colleagues of the University of Texas
Medical Branch, Galveston, that analyzed Medicare claims data for Texas and a
sample from the United States suggests that many colonoscopies performed in
older patients may be potentially inappropriate.
The study background highlights increasing evidence of overuse of the procedure
and that some Medicare patients with negative findings at screening colonoscopy
may be undergoing another screening too early.
The
study results suggest that 23.4 percent of colonoscopies performed in Medicare
beneficiaries 70 years and older in 2008-2009 in Texas and across the country
were potentially inappropriate according to age-based screening recommendations
or the results of a previous screening.
The
rate of inappropriateness by age broke down as follows 9.9% for those 70 to 75;
38.8% for those 76 to 85, and 24.9% for those 86 years or older.
The
colonoscopists with percentages significantly above the mean were more likely
to be surgeons, graduates of US medical schools, medical school graduates
before 1990, and higher-volume colonoscopists.
The
likelihood of undergoing potentially inappropriate colonoscopy depends in part
on where patients live and what physician they see.
“Inappropriate
use of colonoscopy involves unnecessary risk for older patients and consumes
resources that could be used more effectively,” the study concludes.
I
think the most telling part is the variation by physician. Notice surgeons have
higher rates. Why? They want potential surgeries. Graduates of US medical
schools have higher rates. Why? It is the culture of medicine in the US to
test, test, test. Older med school graduates have higher rates because newer
thinking challenges all the testing. And of course those who make their living
performing colonoscopies perform more. No surprise.
It
is a personal choice for you. I had one at 50 and am due at 60. I will do it. I
think the thinking is that as you get older perhaps there is less that you can
do if you find something. In any case, question your physician, whether it is
for your own care or that of a loved one.  

2013-04-10 07:07:16

Source: http://anthonyssong.blogspot.com/2013/04/many-colonoscopies-for-older-adults-may.html