When is the right time to have a colonoscopy?
Imagine a doctor telling you that you are too old for a colonoscopy.
This may happen because the guidelines suggest stopping at age 75, which could be at odds with the fact that as you get older your risk of getting cancer increases.
Lynette Zwirlein follows the prevention advice of her doctor. At the time of the colonoscopy, she complied.
“Well, I’m 80 now, that was last year, I was 79,” Zwirlein said.
That’s five years after the US Preventative Services Task Force’s guideline of 75 years for someone at average risk for colorectal cancer.
“It was put in place because if you have a longevity of no more than 80, then doing it at 75 didn’t make sense,” said Dr. Harsh Duphare, a gastroenterologist at Shorepoint Medical Group.
In other words, it is based on overall life expectancy. But he and most doctors think that shouldn’t be the ultimate criteria for determining whether an elderly patient should have a colonoscopy.
“If they don’t have chronic heart disease or lung disease, they don’t take blood thinners. So, you know, these are healthy people, I don’t think 75 is just denying doing it on a patient who is otherwise healthy,” Duphare said.
Medicare covers colonoscopies regardless of age.
“It detects colon cancer at this stage of polyps and gives you the opportunity to remove these precancerous lesions and thus eliminate the risk of colon cancer,” Duphare said.
With no urgent health issues or concerns about anesthesia, Zwirlein and her doctor set a tentative date for her next colonoscopy.
“He said you probably don’t need another one for 10 years, I remember him saying that,” Zwirlein said.
Screening after age 75 is considered a gray area and should be done on a case-by-case basis.
Statistically, a colonoscopy in people over 75 is linked to a 39% reduction in colorectal cancer.
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