High Demand Colonoscopy's

This is really puzzling. It seems that a "significant number" of Medicare patients are getting unnecessary colonoscopy's. Seriously. In subjecting themselves to frequent colonoscopy's they are not only going through unnecessary discomfort but are increasing the chances of death as well.

Bummer.

As reported in the Wall St Journal . . .

A colonoscopy isn’t something you get just for giggles. Beyond the obvious unpleasantness, there’s the small but real risk of complications that in rare cases can lead to hospitalization or even death.

That’s why the American Cancer Society and other groups recommend that people screened for colorectal cancer using a colonoscopy wait a decade in between tests if no polyps or other signs of potential cancer are found. Polyps are slow-growing, and the benefits of being screened more frequently than that don’t seem to outweigh the risks.

A new study, however, suggests that a significant percentage of Medicare patients are having screening colonoscopies more frequently than that, for no apparent medical reason. Researchers at the University of Texas Medical Branch found that among 24,071 Medicare enrollees who had a negative screening colonoscopy between 2001 and 2003, almost 24% were re-examined within seven years “with no clear indication for the early repeated examination.”

The researchers also found geographic variations, with more than 50% of patients receiving unexplained follow-ups in some areas (including Pueblo, Colo., and Bryan, Texas) and less than 5% in others. Patients in New England and the Pacific and Mountain areas were less likely to have an early repeated procedure.

James Goodwin, an author of the study and director of the Sealy Center on Aging at the University of Texas Medical Branch, tells the Health Blog it’s not clear why patients are being screened too often, but that “any time you have a fee-for-service system, there’s a risk for overutilizing services that are well-reimbursed.” In addition, he says the health community has been “a little too good in terms of selling the message of screening” for cancer. “There really is an excellent acceptance of the benefits of cancer screening in this country, but I don’t think we’ve educated [people] well enough” about the possible risks.

Durado Brooks, director of prostate and colorectal cancers at the American Cancer Society, says that the study is “extraordinarily well done.” He says many physicians worry about missing a potential cancer and underestimate the risks of screening, which are even higher for older people with underlying health problems.

While Medicare has clear rules against reimbursing for screening colonoscopy within ten years of a negative result, researchers said only 2% of the claims with no indication were rejected by the government insurance program. (We have asked the Centers for Medicare and Medicaid Services to comment on this point and update this post when they do.)

Goodwin notes that besides increasing the odds of harm, overuse of screening in some people ties up physicians and resources that could be better used elsewhere. Only about half of eligible adults are being screened for colonoscopy — by any method. The ACS says some screening tests can find the polyps that may turn into cancer; besides colonoscopy every ten years, those include flexible sigmoidoscopy, double-contrast barium enema or CT colonoscopy every five years.

So the next time you feel an urge to have a colonoscopy, pause and think about your decision.

Georgia seniors on Medicare and looking for an  Medicare supplement plan should ask Georgia Insurance Shop for a quote.

 

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