Screenings for the Elderly
We’re not getting any younger. And there are plenty of baby boomers who are suddenly looking at their senior years.
But with all the push to get screened for cancer, when is it ok to stop getting tested, in particular, for colon cancer?
This is something that is mostly missing from preventive care recommendations.
We know when to start screening for breast cancer, and colon cancer, but when does one stop?
The answer: it depends.
“I had a mammogram in august for the second time in twenty years.” So maybe Henrietta Bethune isn’t exactly a poster child for aggressively pursuing good preventative care. But at least she’s at the doctor today.
But will she get a colonoscopy to screen for colon cancer?
“For me to come to the doctor period that is a stretch so for me to go further than that to ask for other things that is huge,” says Henrietta.
You know, maybe it’s ok that Henrietta doesn’t want to go down the road of colon cancer screenings.
At the age of 78, she’s getting up there.
And according to the latest research in the Journal of the American Medical Association, even though colon cancers become more common with age, screening for them in patients over 80 results in smaller gains --just 15 percent-- of the gains in life expectancy seen in younger patients.
Dr. Eileen Callahan, a geriatric specialist at Mt. Sinai Medical Center, says, “If they found the colon cancer or a adenoma, which is a precancerous tumor and it would help to say what would you want to do with the results?”
And that’s the bottom line: what are you going to do whether the test is positive or negative?
“If they have heart disease, congestive heart failure, even dementia, we may not want to pursue it, because we may not do anything about it, and that really is an individual decision.It depends what the patient wants to do, if the patient wants to be very aggressive, and the patient is still very healthy and have about a ten year life expectancy they still might opt to do a colonoscopy for colon cancer,” states Dr. Callahan.
The number of screening colonoscopies in elderly U.S. patients has increased dramatically since Medicare coverage was approved in 2001.
However, colonoscopy in very elderly patients is associated with lower procedural completion rates and possibly higher complication rates.
The study raises the question: what about other cancers? And what should be done in individuals 80 and up?
“There are things like vision, hearing, high blood pressure screening, those should really continue for the life of a patients because that really comes down to quality of life issue,” says Dr. Callahan.
Henrietta’s quality of life is just fine, thank you. “I don’t have anything wrong with me I am healthy,” she says.
And who can argue with her?
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