Why You May Be Wasting Your Time and Money on This Test

Why You May Not Need a Colonoscopy If You Have Few Years Left

Colonoscopy is a common screening test for colorectal cancer. It involves inserting a thin tube with a camera into your colon to look for polyps or abnormal growths that could turn into cancer over time. But did you know that colonoscopy may not be necessary or beneficial for everyone? 😮

In fact, some older adults with few years left may be advised to skip colonoscopy altogether. Why? Because the potential harms of the procedure may outweigh the benefits in this group of people. 🤔

In this article, we will explain why colonoscopy may not be the best option for some seniors and what other alternatives they have. We will also share some tips on how to make informed decisions about your colorectal cancer screening with your doctor. 🙌

The Risks and Benefits of Colonoscopy

Colonoscopy is considered the gold standard for colorectal cancer screening because it can detect and remove polyps before they become cancerous. It can also find colorectal cancer at an early stage when it is easier to treat.

However, colonoscopy is not without risks. Some of the possible complications include bleeding, infection, perforation (a hole in the colon), anesthesia reactions, and missed lesions. These risks are higher in older adults who may have other medical conditions or take medications that affect blood clotting or bowel function.

Moreover, colonoscopy may not provide much benefit for older adults who have a limited life expectancy due to age or other serious illnesses. This is because most polyps take 10 to 15 years to develop into cancer (1), so removing them may not prevent colorectal cancer from occurring in these individuals.

In addition, most older adults who undergo colonoscopy do not have advanced polyps or colorectal cancer that require further treatment (2). Yet most of them are advised to repeat the procedure even if they are unlikely to live long enough to benefit from it (3).

How Often Should You Have a Colonoscopy?

The answer depends on your age, health status, family history, and prior screening results. According to the American Cancer Society (4), people at average risk of colorectal cancer should start regular screening at age 45 with one of these options:

A stool-based test (such as fecal immunochemical test or FIT) every year
A multi-targeted stool DNA test (such as Cologuard) every 3 years
A visual exam of the colon and rectum (such as colonoscopy or CT colonography) every 5 or 10 years

People who are in good health and have a life expectancy of more than 10 years should continue regular screening until age 75.

People between ages 76 and 85 should make individual decisions about screening based on their preferences, overall health, prior screening history.

People over age 85 should no longer get screened for colorectal cancer.

What Are Some Alternatives to Colonoscopy?

If you are an older adult with few years left or have other reasons to avoid colonoscopy (such as cost or inconvenience), you may want to consider other screening tests that are less invasive and risky.

Fecal Immunochemical Test (FIT): This test checks for hidden blood in your stool that could indicate polyps or cancer. You collect a small sample of your stool at home using a kit provided by your doctor or pharmacy and mail it back for analysis. You need to do this test every year if you choose this option.
Multitargeted Stool DNA Test (Cologuard): This test also checks for blood in your stool as well as DNA changes that could signal polyps or cancer. You collect an entire bowel movement at home using a special container provided by your doctor or pharmacy and mail it back for analysis. You need to do this test every 3 years if you choose this option.
CT Colonography (Virtual Colonoscopy): This test uses X-rays and computer software to create images of your colon and rectum (such as colonoscopy or CT colonography) every 5 or 10 years

These tests are less likely to cause complications than colonoscopy. However, they are not as accurate as colonoscopy in finding polyps or cancer. If you have a positive result from any of these tests, you will need to have a colonoscopy to confirm the diagnosis and remove any suspicious lesions.

How to Make Informed Decisions About Your Colorectal Cancer Screening

The decision to have or not have a colonoscopy is not easy. It involves weighing the risks and benefits of the procedure for your specific situation. You also need to consider your personal values and preferences.

That’s why it is important to talk to your doctor about your colorectal cancer screening options. Your doctor can help you assess your risk of colorectal cancer based on your age, health status, family history, and prior screening results. Your doctor can also explain the pros and cons of each screening test and answer any questions you may have.

Some questions you may want to ask your doctor include:

What are my chances of getting colorectal cancer in my lifetime?
How effective is colonoscopy in preventing colorectal cancer?
What are the possible complications of colonoscopy?
How often do I need to have a colonoscopy?
What are some alternatives to colonoscopy?
How accurate are these alternative tests in finding polyps or cancer?
What happens if I have a positive result from an alternative test?
How much do these tests cost and are they covered by my insurance?

The bottom line is that you should make an informed decision about your colorectal cancer screening that reflects your personal goals and values. There is no one-size-fits-all answer for everyone.

The Takeaway

In summary,

Colonoscopy is a common screening test for colorectal cancer that can detect and remove polyps before they become cancerous.
However,colonoscopy may not be necessary or beneficial for some older adults with few years left because the potential harms of the procedure may outweigh the benefits in this group of people.
In fact,some older adults who undergo colonoscopy do not have advanced polyps or colorectal cancer that require further treatment yet most of them are advised to repeat the procedure even if they are unlikely to live long enough to benefit from it.
If you are an older adult with few years left or have other reasons to avoid colonoscopy (such as cost or inconvenience), you may want to consider other screening tests that are less invasive and risky such as fecal immunochemical test (FIT), multitargeted stool DNA test (Cologuard), or CT colonography (virtual colonoscopy).
You should talk to your doctor about your colorectal cancer screening options and make an informed decision that reflects your personal goals and values.

Sources

American Cancer Society. Colorectal Cancer Risk Factors.https://www.cancer.org/cancer/colon-rectal-cancer/causes-risks-prevention/risk-factors.html.
American Cancer Society. American Cancer Society Guideline for Colorectal Cancer Screening.https://www.cancer.org/cancer/colon-rectal-cancer/detection-diagnosis-staging/acs-recommendations.html.

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Isabella Wong

Writer at CouldBeInteresting

Ni hao! My name is Isabella Wong, and I am a writer of Chinese descent. Born and raised in Hong Kong, I bring a unique perspective to my writing that is heavily influenced by my cultural heritage. I am passionate about exploring the intersection of East and West, and I love to write about the challenges of navigating multiple identities in a globalized world. In my free time, I enjoy practicing calligraphy, learning new languages, and sampling different types of tea.