Elderly warned to reduce colon tests

CHICAGO -- Many older Americans get repeat colon cancer tests they don't need and Medicare is paying for it, suggests a recent study.

Almost half of the Medicare patients in the study had had a colonoscopy less than seven years after getting normal results from an earlier test. The test is recommended just every 10 years, starting at age 50, for people at average risk whose initial test is normal.

The study showed that among those 80 and older, one-third had a repeat exam within seven years of the previous colonoscopy. That's an age group that can skip the test altogether if no problems have been spotted before.

The U.S. Preventive Services Task Force recommends against routine colon cancer screening for most people 76 to 85 -- and says for those older than 85, screening risks outweigh the benefits.

The older you are, the more likely you are to die from other causes before cancer becomes deadly, the study authors said.

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

In the study, researchers chose a sample of Medicare claims from more than 200,000 patients over 65 who received colonoscopies between 2001 and 2008. The number of patients in the sample totaled 24,071 -- all people considered at normal risk for colon cancer.

Only 27 percent of all study patients with frequent exams had symptoms that might have raised suspicion of cancer, including abdominal pain, change in bowel habits, and weight loss. The study appears in Monday's Archives of Internal Medicine.

The colonoscopy, considered one of the most effective screening tests available, uses a thin flexible tube to examine the intestines.

The exam is generally pretty safe, but does have risks that occur more often with older patients, including complications from sedation, accidental perforation of the colon and bleeding.