1 in 4 Colonoscopies in Medicare Patients Inappropriate According to University of Texas Study

Though a conoloscopy is one of the most effective cancer screenings for colon cancer, a new study shows that older Americans undergoing the procedure may not be getting an adequate treatment.

A new study by researchers at the University of Texas Medical Branch at Galveston shows that one out of four colonoscopies paid for by Medicare is potentially inappropriate under current screening guidelines set forth by the United States Preventive Services Task Force.

The USPSTF says a colonoscopy is inappropriate when it is repeated within a 10 year period after a negative screening results in a patient 70 to 75 who is not experiencing symptoms. A routine screening colonoscopy is not recommended for patients 76 to 85 years, and any screening at all is discouraged in patients that are older than 85.

Researchers looked at data on all Medicare patients in Texas 70 and older who had colonoscopies during a one-year period between 2008 and 2009. They then examined data on five percent of the 70 and older Medicare patients throughout the United States who had colonoscopies during the same period. The researchers found that 23.4 percent of the colonoscopies paid for by Medicare were potentially inappropriate based on USPSTF guidelines.

 "Screening colonoscopy comes with a real risk of complications for older adults, such as perforation, bleeding or incontinence," said lead researcher Kristin Sheffield, assistant professor of surgery at UTMB.

While researchers are not saying that patients who have symptoms including anemia, gastrointestinal bleeding or abdominal pain should forgo the procedure, they should insist on further testing.

"At the same time, however, older adults are less likely to benefit from early detection because the natural history of colon cancer usually involves a slow progression from polyp to cancer," said Sheffield.

The data is published online the in JAMA Internal Medicine.