Study: Many Colonoscopies for Seniors Potentially Inappropriate

Almost one of every four colonoscopies performed in Medicare beneficiaries 70 years and older in 2008 and 2009 in Texas and across the country was potentially inappropriate, according to age-based screening recommendations or the results of a previous screening.

Kristin M. Sheffield, Ph.D., and her colleagues of the University of Texas Medical Branch, Galveston, said they found the problem when they analyzed Medicare claims data. “Inappropriate use of colonoscopy involves unnecessary risk for older patients and consumes resources that could be used more effectively,” their study concluded.

The background on the study also reports complications from colonoscopy are more likely in those 75 years or older. 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.

A colonoscopy repeated within 10 years after negative screening results represents overuse, based on guidelines. A screening colonoscopy performed in the oldest age groups also may represent overuse, according to guidelines from the U.S. Preventive Services Task Force and the American College of Physicians.

The U.S. Preventive Services Task Force recommends against routine screening for colorectal cancer in adults 76 to 85 years of age. There may be considerations that support colorectal cancer screening in a patient, but the U.S. Preventive Services Task Force recommends against screening for colorectal cancer in adults older than age 85 years. 

For more about the study, see http://www.researchgate.net/publication/235905911_Potentially_Inappropriate_Screening_Colonoscopy_in_Medicare_Patients_Variation_by_Physician_and_Geographic_Region?ev=prf_pub.