Colon Screenings Don't Follow Guidelines, Study Suggests

April 7 -- MONDAY, April 6 (HealthDay News) -- Despite clear guidelines recommending that older people undergo a colonoscopy only if they expect to live at least four more years, a new study reveals that seriously ill elderly men in the United States are being screened for colon cancer on par with healthy people.

The finding specifically reflects the experiences of men seeking care from a U.S. Veteran Affairs hospital, but it suggests that screening practices in general might not hone closely to American Cancer Society protocols.

"Basically what we found is that, regardless of an elderly individual's health, the more often he goes to the doctor, the more likely it is he is going to get a colonoscopy, whether or not it's appropriate," said the study's lead author, Dr. Louise C. Walter, from the geriatrics division at the San Francisco Veterans Affairs Medical Center.

"The problem could reflect a larger systems issue, in that, on the one hand, if you're older and well, very likely you're not seeing physicians often and not getting a colonoscopy screening when it could be very beneficial," she added. "On the flip side, when seniors get sick, they have many more medical visits and are more prone to getting a lot of stuff done to them -- including colonoscopies -- that can actually be harmful and distracting from the real problems at hand."

The study is in the April 7 issue of Annals of Internal Medicine.

Current Cancer Society guidelines suggest that after age 50, men and women with an average risk for developing colorectal cancer should be screened to uncover early signs of the disease. Options include a colonoscopy once every 10 years or one of three procedures -- a flexible sigmoidoscopy, a virtual colonoscopy or a double-contrast barium enema procedure -- that should be done every five years. Various yearly stool analyses are also available.

However, health experts point out that elderly people with serious or even terminal illnesses might not derive practical benefit from the identification and treatment of colon cancer, which is why colonoscopies are not recommended if a person's life expectancy is not more than four years.