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I’m weighing in on this growing controversy
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Story-At-a-Glance
Hey, Matt Cook here, and almost every doctor will tell you that once a man hits a certain age he MUST get a colonoscopy…
I will never get one though.
I think they do a lot more harm than good.
Here’s why…
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Does a man actually need a colonoscopy?
Colonoscopies are used to diagnose colon cancer and inflammatory diseases of the gastrointestinal system.
They can be helpful when people have indicators of these diseases.
They are also used routinely to assess people who may not have clear indicators of these diseases…
…but who are at an age where they are at a slightly increased risk of being diagnosed.
The idea is that we can detect diseases early and treat conditions that may otherwise become fatal.
But there are risks associated with colonoscopies. Perforations can be fatal, and many people report never having normal gastrointestinal function afterward.
So, we must be careful about when and why we perform these procedures.
And many doctors are performing many unnecessary colonoscopies.
It’s undoubtedly one of those things you might want to get a second opinion on…
The human research was carried out at The University of Texas Medical Branch in Galveston. This paper was published in JAMA Internal Medicine.
The researchers were looking into rates of unnecessary colonoscopies in older people.
“Inappropriate use of colonoscopy involves unnecessary risk for older patients and consumes resources that could be used more effectively.
They analyzed data from Texas and compared that with data from all across the United States over 9 years.
“This retrospective cohort study used Medicare claims data for Texas and a 5% sample from the United States from 2000 through 2009.”
The researchers analyzed data from older people – over the age of 70.
“Colonoscopies were classified as screening in the absence of a diagnosis suggesting an indication for the procedure.”
The researchers set out some reasonable grounds for deeming procedures unnecessary or inappropriate.
“Screening was considered potentially inappropriate on the basis of patient age or occurrence too soon after colonoscopy with negative findings.”
They then quantified the percentage of inappropriate colonoscopies carried out by each doctor…
…and also looked at what was happening in different hospitals and regions.
“The percentage of patients undergoing potentially inappropriate screening colonoscopy was estimated for each colonoscopist and hospital service area.”
Almost 1 in 4 colonoscopies in people over 70 in Texas were inappropriate.
“23.4% for the overall Texas cohort were inappropriate. 10% in patients aged 70 to 75 were unnecessary.”
The highest risk group for unnecessary colonoscopies was 76 to 85 years old…
…or nearly 40% of colonoscopies carried out were deemed unnecessary.
“39% in patients aged 76 to 85.”
The pattern was not consistent either – they found massive variation in rates of unnecessary colonoscopies, according to the doctor.
“There was considerable variation across the 797 colonoscopists in the percentages of colonoscopies performed that were potentially inappropriate.”
Some colonoscopists were deemed to have carried out 45% more colonoscopies than could be justified by the researchers.
“73 colonoscopists had percentages significantly above the mean (24%), ranging from 28% to 45%.”
Others were far less likely to carry out unnecessary colonoscopies.
Medicine is not an objective science – different doctors do things differently – and some are safer than others.
“119 had percentages significantly below the mean, ranging from 6.7% to 18%.”
The researchers found that older American doctors were more likely to carry out unnecessary colonoscopies.
“The colonoscopists with percentages significantly above the mean were more likely to be surgeons, graduates of US medical schools, medical school graduates before 1990.”
The researchers found a similar variation in rates of unnecessary colonoscopies all across the United States.
“There was also geographic variation across Texas and the United States, with percentages ranging from 13% to 35% in Texas and 19% to 30% across the United States.”
Unnecessary colonoscopies are widespread, particularly in older people, and the rates of unnecessary colonoscopies vary significantly, according to the doctor.
“Many colonoscopies performed in older adults may be inappropriate. The likelihood of undergoing potentially inappropriate colonoscopy depends in part on where patients live and what physician they see.”
You should always consult your healthcare practitioner for guidance on medical diagnosis and treatment.
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