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Researchers at the University of Michigan this week found that recommendation guidelines for colon cancer screenings may be contributing to both overuse of screening in patients in poor health and underuse of screening in patients in good health.
Physicians begin recommending colon cancer screening for average risk patients starting at age 50, and most insurers use quality measures that encourage 50- to 75-year olds to get screened. However, the results of a recent study indicate that it may be beneficial to include benefit to the patient as part of these quality measures instead of age alone.
Specifically, the study, published in BMJ this week, found that a 75-year-old in poor health — defined here as someone whose life expectancy is less than five years — is "significantly more likely" to receive colon cancer screening than a 76-year-old who is healthy and therefore more likely to benefit from screening. The researchers suggest this discrepency is due to the cut off in quality measures at age 75.
"By focusing on age alone, we are not screening everyone who is likely to benefit. And some people who are not likely to benefit are being screened unnecessarily, like those who have serious health problems. If the system focused on age and health status rather than age alone, we'd have better health outcomes," said lead study author Dr. Sameer Saini in an interview about the study posted on YouTube. "Colon cancer is a common and serious cancer and we know that screening for colon cancer can reduce both illness and death from colon cancer."
You can watch the whole interview with Dr. Saini below.