Colon Screenings Don't Follow Guidelines, Study Suggests

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However, health experts point out that elderly people with serious or even terminal illnesses might not derive practical benefit from the identification and treatment of colon cancer, which is why colonoscopies are not recommended if a person's life expectancy is not more than four years.

To gauge adherence to such advice, Walter and her colleagues reviewed the records of 27,068 men, 70 and older, who had been cared for between 2001 and 2002 at four VA centers.

Though only 46 percent of them had been screened for colon cancer during this time, the researchers found some degree of under-screening and over-screening.

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For example, 47 percent of men with a life expectancy of more than five years and no serious health complications had been screened, but 41 percent of men with severe illness and less than a five-year life expectancy were also screened.

In fact, the study found, these ill elderly men were just as likely, or even more likely, than their healthy counterparts to be screened for colon cancer if they had visited a VA facility four or more times.

The researchers pointed out that their findings might not reflect the state of affairs outside the VA hospital system, and that some screening procedures might have been performed for reasons other than to identify colon cancer.

But they suggested that more attention be paid to how such screenings are administered among seniors.

"It's not like we're doing too little or too much," Walter said. "But colon cancer screening rates need to be higher in healthy older people and lower in older sicker people. And to achieve that, we have to be more thoughtful about who's getting what and try and target it a little bit better."

Dr. George Chang, an assistant professor of surgical oncology at the University of Texas M.D. Anderson Cancer Center in Houston, said the findings and analysis "certainly make a lot of sense," but he called the situation complex.

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