Recent studies show retirees on Medicare may have too many colonoscopies. Adults over the age of 50 should have routine colorectal screening, especially if you are in a high risk category. But how many colonoscopies are too many and at what age does the risk associated with a colonoscopy outweigh the benefit?
People of a certain age will not only remember Readers Digest (yes, it’s still around) but will probably remember the talking body parts. These stories gave us a tour of Joe’s body, explaining the function of the organ or body part and giving us medical insight in lay terms.
Don’t expect this to be “I am Joe’s colon” but perhaps you will learn something that could save your life.
Too many colonoscopies?
At what age does the colonoscopy become too dangerous for the patient? Studies show that a colonoscopy every 3 – 5 years (more often if you are considered high risk) can be a life saving maneuver. But is there an age when you should just say no?
After reading about the benefits of routine colorectal screening Bill Fullington scheduled his first colonoscopy …… at age 80. But Bill’s exam was anything but routine.
The doctor removed two small polyps — “the size of BBs,” Mr. Fullington said — and sent him home to recover. The next day, “I woke up screaming in pain.”
At the emergency room at Brookwood Medical Center, tests showed that the procedure had perforated his colon. Mr. Fullington underwent a colostomy and spent a week in intensive care — and that was just the beginning.
Colonoscopies are normally performed on an outpatient basis and are covered under Medicare Part B. If your exam is routine, meets the guidelines for your age and family history and no abnormalities are found the procedure MAY be covered with no out of pocket cost.
If the exam is prompted by symptoms or abnormalities are discovered your out of pocket expenditure can still be nominal under Part B especially if you have Medigap plan F or G.
Like Bill, you may read that regular colon screening is good but you may not know that colonoscopies can become dangerous over a certain age.
in 2008, just a few months after Mr. Fullington’s colonoscopy, the United States Preventive Services Task Force reviewed years of research and recommended against routine screening for colorectal cancer in adults over age 75 and against any screening in those over 85.
Some physicians, especially those with medical school training outside the U.S. may have a tendency to recommend unnecessary colonoscopies.
Why not screen everyone? Because, he explained, at older ages the benefits diminish. “It’s difficult to have this conversation, to say, ‘You don’t need this because you’re not going to live long enough to benefit,’” he acknowledged. But colon cancer develops slowly, and in the many years it takes for small polyps to evolve into cancer, if they do, most old people will have died of other diseases.
Not all polyps become cancer but all colon cancer begins as a polyp. The general consensus is it takes 5 – 10 years for an abnormal polyp to become cancer.
Preparation can be dangerous
Most people who have had a colonoscopy will tell you the worst part was the advance preparation to prepare your colon for the exam.
Preparation for a colonoscopy, merely unpleasant for most of us, can take a steep physical toll on the very old. They can become incontinent, setting off a cycle of prescriptions for drugs to stop diarrhea and then constipation. The preparations can disrupt eating and sleep. “It can throw people off for a long time,” Dr. Goodwin said.
“It would be a very bad idea for people with moderate dementia,” he added, and that’s a significant proportion of the 85-plus population. They may not understand the test’s purpose or be able to comply with the prep directions.
If you are on Medicare and are age 75 or older you might want to get a second opinion if your doctor is pushing a colonoscopy.
Medicare supplement rates have been coming down in the last few years and newer plans with cost sharing are saving a lot of money for Georgia retirees. If you have Medigap plan F with Blue Cross or Mutual of Omaha you are probably paying too much.
We have rates on more than 170 different Medicare supplement plans and can probably find one that is right for you. Instant online quotes.
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