Do Seniors Need Colonoscopies?

Dear Donna:

My father is 81 years old. He last had a colonoscopy at 70. It’s always been tough getting him to comply with doctor’s orders, especially when it comes to this screening.

We have an appointment with his primary care doctor in two weeks. I suspect the topic will come up. At his age, how necessary is it to have this procedure again? While he’s fairly healthy, his age alone has me worried.

Do you know if older adults still need colonoscopies? Any information would be appreciated.

Sincerely,

Stefanie in Saginaw, MI

 

Age and Colonoscopy: What to Consider

 

Dear Stefanie:

What a great question! It’s one residents at Heritage Senior Communities likely have too.

Colonoscopies are a preventive screening typically recommended for adults over the age of 50. Research shows colonoscopies save lives. Colon cancer is the fourth leading cause of death in this country. While most people know they should get one, not everyone follows through.

The unpleasantness of the prep combined with the perceived loss of dignity of the procedure are the leading reasons people put it off. For older adults, there are other concerns. The side effects of sedation and the risk of a bowel perforation are two.

Adults over the age of 65 are at 30% higher risk for perforation. For seniors, this can be life-threatening. If you are a senior or the adult child of one, here’s what to consider before scheduling a colonoscopy.

Colonoscopies and the Older Adult

 

1. Age: In 2008, the United States Preventive Services Task Force published updated guidelines on colorectal cancer screening to include recommendations based on age. They recommend colorectal cancer screening using fecal occult blood testing, sigmoidoscopy, or colonoscopy from age 50 through 75. After age 76, they recommend against a colonoscopy unless there are special circumstances.
2. Last screening: Physicians also consider the date of last colonoscopy, especially for those between the age of 65 and 75. Because colon cancer typically grows slowly, seniors who have had clear colonoscopies might not be required to have another. The decision should be made on a case-by-case basis.
3. Alternative screenings: Another suggestion is to talk with your father’s physician about alternatives to colonoscopy. There are several, such as a sigmoidoscopy or a fecal occult blood test. Cologuard, a newer, non-invasive colon cancer test, is covered by Medicare. Research shows it to be effective at detecting colon cancer, even in early stages.

 

While colonoscopy is likely to be considered the gold standard in colon cancer screenings for the foreseeable future, it’s essential to weigh the benefits against the risks with your father’s physician.

Hope this helps, Stefanie!

Kind regards,

Donna