Do I Need Do Colonoscopy Again After Bad Tumors Removed From First Time

May 09, 2022 Post a Comment

Some People Getting Colonoscopy Screening Too Frequently

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After a normal colonoscopy when no polyps are found, guidelines telephone call for a repeat examination in 10 years.

However, virtually half of Medicare patients with a negative colonoscopy got another exam within 7 years, and for 1 in iv, in that location was no articulate evidence that they needed ane.

Because colonoscopies have existent risks and are expensive, over-testing can be both dangerous and costly. Given express numbers of physicians who do colonoscopies, unnecessary procedures add to long waiting lists for screening and for necessary follow-upwardly exams.

Although Medicare regulations telephone call for reimbursement only after 10 years in cases where the offset procedure didn't find a problem, payments are being fabricated for earlier exams. In fact, Medicare denied payment for only 2 percent of colonoscopies for which in that location was no articulate indication of need.

Researchers at the Academy of Texas in Galveston reviewed a representative sample of Medicare claims for colonoscopy betwixt 2001 and 2003. Since they were looking for average-gamble patients who had a negative screening colonoscopy, they filtered out any tests that included removing a polyp or a biopsy or other process is washed during the exam. They also removed any colonoscopies that included a diagnosis such as bleeding or hurting and any that were washed for patients who had a Medicare claim in the previous 3 months that included a diagnosis or symptoms of colorectal disease that might have indicated the demand for a diagnostic colonoscopy.

In their sample of 5% of the Medicare population:

236,145 Medicare patients 66 and older had a colonoscopy in 2001-2003.
114,468 had a negative exam with no polyps removed, no biopsies or other procedures.
24,071 had a negative screening colonoscopy later all possible medical reasons for doing the test were eliminated.

The research team then looked for repeated colonoscopies within 5 and 7 years of the get-go test. Again they eliminated whatsoever exams for which diagnosis or other Medicare claims indicated a good reason to echo the test. If they couldn't find a reason, they classified the colonoscopy as repeated with no clear indication.

In their sample of 24,071 who had a completely negative screening colonoscopy between 2001 and 2003, 8,608 had some other colonoscopy within 7 years, and for 3,656 no reason other than routine screening could exist constitute for doing the test.

Even so, but 86 patients (2 percent) actually had payment denied past Medicare.

Although the The states Preventive Services Task Force recommends against routine screening for people between ages 75 and 84 and against any screening for those over 85, i-3rd of patients who were 80 or older at their initial negative screening colonoscopy had another exam within 7 years.

The study authors pointed out,

This is of special concern, given the increased potential for complications and decreased benefit of this examination in the very old.

Repeating a colonoscopy early later on a negative exam was more likely to occur when:

Endoscopists doing the outset colonoscopy did more than than ane,200 procedures a twelvemonth.
The exam took place in a dr.'s part rather than a hospital or ambulatory surgical center.
The patients were male person.
The exam took identify in the Eye Atlantic or North Fundamental regions of the The states.
Patients had less than loftier school education.

For boilerplate-risk patients without a family history of inherited colorectal cancer, the natural development of cancer from even quite big polyps is slow. Before the era of colonoscopy, doctors at the Mayo Clinic followed 226 patients who had barium enemas with advanced adenomas (over 1 cm) for 5, 10, and even 20 years. During that fourth dimension only 2.5% became cancer at v years and 8% at 10 years. Seven out of ten cancers were found at an early phase before spreading to lymph nodes or distant sites.

After analyzing their results, James Goodwin, MD, and his colleagues at the University of Texas concluded,

A large proportion of Medicare patients who undergo screening colonoscopy do and then more often than recommended. Electric current Medicare regulations intending to limit reimbursement for screening colonoscopy to every 10 years would not announced to exist effective.

SOURCE: Goodman et al., Archives of Internal Medicine, online commencement May ix, 2011.

What This Means for Patients

Although the research was washed in Medicare patients over 65, at that place is no reason to believe that younger patients are not also beingness screened more than ofttimes than guidelines telephone call for.

After your screening colonoscopy, be sure that yous have a copy of the results that describe if adenomas (polyps) were found and what their size and description was. If you don't understand the report, ask your doctor to explain it.
Check to see if the recommendation for the next screening exam fits within the guidelines for colorectal cancer screening. If the render recommendation is sooner that guidelines call for, ask why!

For people at average adventure of colorectal cancer, colonoscopy screening is recommended kickoff at age 50 and and then every 10 years unless adenomas or cancer are found.

The U.s. Preventive Services Task Forcefulness says that elderly people betwixt 75 and 84 should not exist routinely screened for colorectal cancer and those over 85 should not be screened at all. If your older relative is getting colonoscopy recommendations that doesn't fit the guidelines, ask why. They are at college risk for complications from the process and may well not benefit from screening.

But remember:

Symptoms of colorectal cancer at whatever fourth dimension -- even afterwards a negative screening colonoscopy -- and at any age telephone call for diagnostic colonoscopy .
People with a family history of colorectal cancer or a personal medical history of cancer, adenomas, or inflammatory bowel affliction (ulcerative colitis or Crohn's disease) are not at average take a chance. They should follow screening and surveillance programs for increased and high gamble, including kickoff earlier than fifty and existence screened more often.