Colon Cancer Screening Targets Wrong Elders, Study Finds

By Steve Tokar, NCIRE | April 6, 2009

Healthy patients age 70 and older who could benefit from colon cancer screening are not being adequately screened, while ill patients are being screened unnecessarily, according to a study of more than 27,000 veteran patients led by researchers at the San Francisco VA Medical Center.

"Putting someone with heart failure or dementia through a colon cancer screening test such as a colonoscopy is problematic, potentially dangerous, and unlikely to benefit the patient - yet that's exactly what we're doing," says lead author Louise C. Walter, MD, a staff physician at SFVAMC and an associate professor of medicine at the University of California, San Francisco. "At the same time, we're not screening healthy elders."

In the study, which appears in the April 7, 2009 issue of "Annals of Internal Medicine," the authors tracked older patients at four VA medical centers around the United States over a two-year period to determine whether they were screened for colon cancer, and then followed the patients for five years or until they died. They found that only 47 percent of healthy elders with life expectancies of five years or more were screened for colon cancer, while 41 percent of elders with severe illnesses and less than five-year life expectancy were screened.

"This goes against colon cancer screening guidelines, which state that physicians should recommend screening to healthy elders with long life expectancy, and not to elders in poor health," says Walter. "Instead, age was the main predictor of screening. The older you were, the less likely you were to be screened, regardless of your health status."

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