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Do Older People Need a Screening Colonoscopy?

A screening colonoscopy is important for detecting early colon polyps and cancer, but at what age should you stop getting them? Find out what a new study shows.

More people are choosing to get a screening colonoscopy these days as it becomes clear that lives can be saved by catching pre-malignant polyps and cancers early when a cure is possible. Most guidelines recommend a screening colonoscopy in people over the age of fifty, unless there’s a family history of colon cancer which makes earlier screening important. But what about the other end of the spectrum? At what age should screening colonoscopies be stopped?

What Are the Guidelines?

Previously, it’s been recommended that adults get a screening colonoscopy up to the age of seventy-five. Some experts have argued for screening into the eighties since the number of cases in this age group is on the rise. Now, a new study suggests that it may not be necessary to screen for colon polyps and cancers after the age of seventy. This study, which was published in Family Practice News this month, suggests that not only is a screening colonoscopy in people over the age of seventy not cost effective, it may not prolong life expectancy because colon polyps can take many years to become cancer. The risk of complications from screening colonoscopy is also higher in the older age group with the risks of puncturing the colon or hemorrhaging from the procedure almost double.

Is a Screening Colonoscopy the Only Way to Screen?

Some doctors are recommending testing the stool regularly for microscopic blood as a means of detecting polyps and colon cancer. Although this is a safe, low cost way to screen, blood may be in the stool for a variety of reasons unrelated to cancer such as the presence of hemorrhoids. Finding blood in the stool on screening could still end up requiring a colonoscopy to rule out colon cancer.

Should People Over Seventy Still Get a Screening Colonoscopy?

Colon cancer becomes increasingly more common with age, and not screening people over the age of seventy will result in some treatable colon cancers being missed; but there is also the small risk of perforating or tearing the colon which can be life threatening. For those who have been regularly screened up to the age of seventy with no abnormal polyps or cancers, it may be safe to stop screening colonoscopies since any polyp that appears after that time will take a long time to develop into a cancer. In people who are at high risk of colon cancer because of family history, continued screening is advisable. For those who choose to stop screening colonoscopies, screening could continue on a yearly basis with stool testing for microscopic blood.

Of course, these are all issues that should be discussed with a personal family doctor who is aware of any family history and other issues that might increase the risk of colon cancer. Not even the experts can completely agree on this issue.

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