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Study Questions Overuse of Colonoscopy in Medicare Patients
Date:5/10/2011

By Steven Reinberg
HealthDay Reporter

MONDAY, May 9 (HealthDay News) -- Among Medicare patients, colonoscopies are often done more frequently than recommended, a new study finds.

But at the same time, a second study finds that older patients seen at VA hospitals may not always be getting the follow-up colonoscopies they need even when recommendations call for them, such as cases in which blood is detected in the stool.

Both reports were published in the May 9 online edition of the Archives of Internal Medicine.

Colonoscopy -- a test in which a doctor uses a thin flexible tube to view the entire lining of the colon and rectum -- is usually recommended when someone shows possible signs of colon cancer, such as blood in the stool. The American Cancer Society also recommends colonoscopy as a colon cancer screening tool for men and women, beginning at age 50 and at 10-year intervals after that.

"The natural history of polyps going to cancer is incredibly slow -- like 20 years," said Dr. James S. Goodwin, the George & Cynthia Mitchell Distinguished Chair in Geriatric Medicine and director of the Sealy Center on Aging at the University of Texas Medical Branch in Galveston and lead researcher on the first study.

That is why the recommendation, for most people, is a colonoscopy screening every 10 years, he said. "Colonoscopy is not benign. One of every 1,000 people winds up in the hospital because of a complication," Goodwin noted.

For the study, Goodwin's group collected data on 5 percent of Medicare patients from 2000 through 2008. Among these patients, the researchers identified 24,071 who had normal colonoscopies. They then looked at when the next colonoscopy was done.

They found that 46.2 percent of the patients had another colonoscopy within seven years. Out of those, more than 42 percent had no indication of a clear medical need for one so soon after the previous screening.

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