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Monday, April 13, 2009

Colonoscopies for Everyone! S.F. Study Finds Many Elders are Being Unnecessarily Probed.

Posted By on Mon, Apr 13, 2009 at 6:30 AM

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Oh, the joys of a colonoscopy -- the days of heavy laxatives, the all-Jell-O diet, the invasive rectal surgery, and the throbbing recovery. Sound like the kind of thing a frail old person on death's door should be subjected to (other than the Jell-O). Nope. But that's who's getting probed, according to an exhaustive recent study run by the San Francisco VA Medical Center and published in the most recent copy of "The Annals of Internal Medicine" (sorry, can't resist joking about knocking one of the N's out of "Annals").

According to the study of 27,000 elderly patients, folks who are too sickly and frail to withstand rigorous colon cancer screening techniques are routinely getting run through the ringer (literally) while the healthy seniors who should be getting the treatments are often neglected.

"Putting someone with heart failure or dementia through a colon cancer

screening test such as a colonoscopy is problematic, potentially

dangerous, and unlikely to benefit the patient - yet that's exactly

what we're doing," says the study's lead author, Dr. Louise Walter, a staff

physician at the VA and an associate professor of medicine at U.C. San Francisco.

The two-year study tracked patients at four VA medical centers and determined that only 47 percent of healthy seniors with life expectancies of at least five more years were screened for colon cancer -- while 41 percent of those who were extremely sick and not likely to last another five years were screened. That's not how it's supposed to go: Healthy older folks are more likely to benefit from screening, not the sick and weak.

The study also noted that those who visit their doctor most often are the ones most frequently screened. Since, intuitively, sick people go to the doctor more often, the healthy folks who could really benefit from colon cancer screenings are not being helped.

"We have to find a way to reach out to healthy people and say, 'come in for your preventive health visit,'" says Walter. Downplaying the cold metal tube that'll be shoved up your ass might help.

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About The Author

Joe Eskenazi

Joe Eskenazi

Joe Eskenazi was born in San Francisco, raised in the Bay Area, and attended U.C. Berkeley. He never left. "Your humble narrator" was a staff writer and columnist for SF Weekly from 2007 to 2015. He resides in the Excelsior with his wife, 4.3 miles from his birthplace and 5,474 from hers.


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