Over 75?
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From: Califchief on 7 Oct 2008 00:42 Government health task force says those over 75 don't need routine screening for colon cancer 10-06-2008 6:23 PM PHILADELPHIA -- Most people over 75 should stop getting routine colon cancer tests, according to a government health task force that also rejected the latest X-ray screening technology. The U.S. Preventive Services Task Force _ in a break with other medical and cancer organizations _ opted not to give its stamp of approval to the newest tests: CT colonography, an X-ray test known as virtual colonoscopy, and a stool DNA test. The panel said more research is needed. The task force for the first time did endorse three tests and said everyone age 50 to 75 should get screened with one of them: _ a colonoscopy of the entire colon every 10 years _ a sigmoidoscopy of the lower colon every 5 years, combined with a stool blood test every 3 years _ a stool blood test every year After reviewing research on the tests, the government-appointed panel of independent medical experts concluded that the benefits of detecting and treating colon cancer decline after age 75 and the risks rise. Colonoscopy complications can include infection, perforated colon and reactions to sedatives. Doctors may decide to continue screening those between 76 and 85 because of the patient's medical history and risk factors but there's very little reason to routinely test anyone older than 85, according to the guidelines published in Tuesday's Annals of Internal Medicine. "The risks of screening at that age are too great to justify any possible benefit," said Dr. Michael LeFevre, a task force member from the University of Missouri School of Medicine. The new advice updates 2002 guidelines that did not give an age limit for screening. The task force in August said men over 75 should not be screened for prostate cancer; it didn't recommend for or against prostate screening of men under 75. Colon cancer is the country's 2nd leading cancer killer. Nearly 50,000 Americans are expected to die of colorectal cancer this year. Screening to spot early cancer or precancerous growths has resulted in fewer deaths over the last two decades. Colonoscopy is considered the gold standard but it is not perfect. A long, thin tube with a small video camera is snaked through the large intestine to view the lining and any growths are removed. The task force's stance on CT colonography and the stool DNA test is contrary to recent recommendations from the American Cancer Society, as well as radiology and gastroenterology groups that say the newer tests are effective and could encourage people scared of colonoscopies to get checked out. Only about half of those who need screening have it done. The stool DNA test "has potential but it's an evolving technology," LeFevre said. "It's also likely to have a very high cost." Also in Tuesday's journal are the results of a study that found a newer version of the DNA test was better than an older version or a stool blood test in finding cases of cancer. For virtual colonoscopy, the task force expressed concerns about radiation exposure a patient would receive every 5 years from it, but acknowledged that the level is relatively low compared to other kinds of X-rays. They also worry that it will pick up blips inside and outside the colon that end up being nothing, but lead to more follow-up tests. A member of the American College of Radiology Colon Cancer Committee said it was "surprising and unfortunate that such a well respected group would not come out and endorse CT colonography." "The science is behind us that it works and it works well," said Dr. Judy Yee of the University of California, San Francisco, who has been involved in virtual colonoscopy research. "The goal is to get more Americans screened, and this is counterproductive to that goal." The task force's guidelines could affect whether insurers and Medicare decide to pay for the test, Yee said. The cost of virtual colonoscopy can vary widely but it's generally much cheaper than a traditional colonoscopy, which can run several thousand dollars. If growths are found in a virtual colonoscopy, a traditional colonoscopy is need to remove them. The task force will review its recommendations in 5 years and may make changes if more research emerges, LeFevre said. ___ On the Net: Annals of Internal Medicine: http://www.annals.org/ ___ Blue Wave/QWK v2.12
From: Steve Jordan on 7 Oct 2008 12:28 On October 6, Califchief wrote: > Government health task force says those over 75 don't need routine > screening for colon cancer 10-06-2008 6:23 PM > > PHILADELPHIA -- Most people over 75 should stop getting routine > colon cancer tests, according to a government health task force that > also rejected the latest X-ray screening technology. > > The U.S. Preventive Services Task Force _ in a break with other > medical and cancer organizations _ opted not to give its stamp of > approval to the newest tests: CT colonography, an X-ray test known as > virtual colonoscopy, and a stool DNA test. The panel said more > research is needed. > > The task force for the first time did endorse three tests and said > everyone age 50 to 75 should get screened with one of them: > > _ a colonoscopy of the entire colon every 10 years > > _ a sigmoidoscopy of the lower colon every 5 years, combined with a > stool blood test every 3 years > > _ a stool blood test every year > > After reviewing research on the tests, the government-appointed panel > of independent medical experts concluded that the benefits of > detecting and treating colon cancer decline after age 75 and the > risks rise. Colonoscopy complications can include infection, > perforated colon and reactions to sedatives. > > Doctors may decide to continue screening those between 76 and 85 > because of the patient's medical history and risk factors but there's > very little reason to routinely test anyone older than 85, according > to the guidelines published in Tuesday's Annals of Internal Medicine. > > > "The risks of screening at that age are too great to justify any > possible benefit," said Dr. Michael LeFevre, a task force member from > the University of Missouri School of Medicine. > > The new advice updates 2002 guidelines that did not give an age limit > for screening. > > The task force in August said men over 75 should not be screened for > prostate cancer; it didn't recommend for or against prostate > screening of men under 75. > > Colon cancer is the country's 2nd leading cancer killer. > > Nearly 50,000 Americans are expected to die of colorectal cancer this > year. > > Screening to spot early cancer or precancerous growths has resulted > in fewer deaths over the last two decades. > > Colonoscopy is considered the gold standard but it is not perfect. > > A long, thin tube with a small video camera is snaked through the > large intestine to view the lining and any growths are removed. > > The task force's stance on CT colonography and the stool DNA test is > contrary to recent recommendations from the American Cancer Society, > as well as radiology and gastroenterology groups that say the newer > tests are effective and could encourage people scared of > colonoscopies to get checked out. > > Only about half of those who need screening have it done. > > The stool DNA test "has potential but it's an evolving technology," > LeFevre said. "It's also likely to have a very high cost." > > Also in Tuesday's journal are the results of a study that found a > newer version of the DNA test was better than an older version or a > stool blood test in finding cases of cancer. > > For virtual colonoscopy, the task force expressed concerns about > radiation exposure a patient would receive every 5 years from it, but > acknowledged that the level is relatively low compared to other kinds > of X-rays. > > They also worry that it will pick up blips inside and outside the > colon that end up being nothing, but lead to more follow-up tests. > > A member of the American College of Radiology Colon Cancer Committee > said it was "surprising and unfortunate that such a well respected > group would not come out and endorse CT colonography." > > "The science is behind us that it works and it works well," said Dr. > Judy Yee of the University of California, San Francisco, who has been > involved in virtual colonoscopy research. "The goal is to get more > Americans screened, and this is counterproductive to that goal." > > The task force's guidelines could affect whether insurers and > Medicare decide to pay for the test, Yee said. > > The cost of virtual colonoscopy can vary widely but it's generally > much cheaper than a traditional colonoscopy, which can run several > thousand dollars. > > If growths are found in a virtual colonoscopy, a traditional > colonoscopy is need to remove them. > > The task force will review its recommendations in 5 years and may > make changes if more research emerges, LeFevre said. > > ___ > > On the Net: > > Annals of Internal Medicine: http://www.annals.org/ ___ Blue Wave/QWK > v2.12
From: Steve Jordan on 7 Oct 2008 12:36 Oops. I meant: > On October 6, Califchief wrote: >> Government health task force says those over 75 don't need routine >> screening for colon cancer 10-06-2008 6:23 PM (snip) The USPSTF is the same outfit that recently recommended that no PCa patient =/> 75 receive ANY treatment. None of the members are (1) practicing physicians, nor (2) are they involved in any specialty of interest to cancer patients. Regards, Steve J
From: safire on 7 Oct 2008 14:06 Steve Jordan wrote: > > The USPSTF is the same outfit that recently recommended that no PCa > patient =/> 75 receive ANY treatment. The U.S. Preventive Services Task Force (USPSTF), updating its 2002 report, now recommends against routine prostate cancer screening for men over the age of 75. More evidence is needed to determine if men under 75 could benefit from screening. Does Jordan know the difference between treatment and routine screening? > > None of the members are (1) practicing physicians, Members of the USPSTF The USPSTF comprises primary care clinicians (e.g., internists, pediatricians, family physicians, gynecologists/obstetricians, and nurses). Bruce N. Calonge, M.D., M.P.H. (Chair) Chief Medical Officer and State Epidemiologist Colorado Department of Public Health and Environment, Denver, CO Diana B. Petitti, M.D., M.P.H. (Vice Chair) Adjunct Professor University of Southern California, Los Angeles, CA Allen J. Dietrich, M.D. Professor, Community and Family Medicine Dartmouth Medical School Thomas G. DeWitt, M.D. Carl Weihl Professor of Pediatrics Director of the Division of General and Community Pediatrics Department of Pediatrics, Children's Hospital Medical Center, Cincinnati, OH Kimberly D. Gregory, M.D., M.P.H. Director, Maternal-Fetal Medicine and Women's Health Services Research Cedars-Sinai Medical Center, Los Angeles, CA David Grossman, M.D., M.P.H. Medical Director, Preventive Care and Senior Investigator, Center for Health Studies, Group Health Cooperative Professor of Health Services and Adjunct Professor of Pediatrics University of Washington, Seattle, WA George Isham, M.D., M.S. Medical Director and Chief Health Officer HealthPartners, Minneapolis, MN Michael L. LeFevre, M.D., M.S.P.H. Professor, Department of Family and Community Medicine University of Missouri School of Medicine, Columbia, MO Rosanne Leipzig, M.D., Ph.D Professor, Geriatrics and Adult Development, Medicine, Health Policy Mount Sinai School of Medicine Lucy N. Marion, Ph.D., R.N. Dean and Professor, School of Nursing Medical College of Georgia, Augusta, GA Bernadette Melnyk, Ph.D., R.N., C.P.N.P./N.P.P. Dean and Distinguished Foundation Professor in Nursing College of Nursing & Healthcare Innovation Arizona State University, Phoenix, AZ Virginia A. Moyer, M.D., M.P.H. Professor, Department of Pediatrics Director of the Fellowship Program in Academic General Pediatrics Baylor College of Medicine, Houston, TX Associate Director of Ambulatory Services Texas Children�s Hospital, Houston, TX Judith K. Ockene, Ph.D., M.Ed. Professor of Medicine University of Massachusetts Medical School, Worcester, MA George F. Sawaya, M.D. Associate Professor Department of Obstetrics, Gynecology, and Reproductive Sciences Department of Epidemiology and Biostatistics University of California, San Francisco J. Sanford (Sandy) Schwartz, M.D. Leon Hess Professor of Medicine, Health Management, and Economics University of Pennsylvania School of Medicine and Wharton School, Philadelphia, PA Timothy Wilt, M.D., M.P.H. Professor, Department of Medicine, Minneapolis VA Medical Center University of Minnesota, Minneapolis, MN
From: len on 10 Oct 2008 23:40 On Oct 6, 11:42 pm, califch...(a)fidotel.com (Califchief) wrote: > Government health task force says those over 75 don't need routine screening for colon cancer > 10-06-2008 6:23 PM > > PHILADELPHIA -- Most people over 75 should stop getting routine colon cancer tests, according to a government health task force that also rejected the latest X-ray screening technology. > > The U.S. Preventive Services Task Force _ in a break with other medical and cancer organizations _ opted not to give its stamp of approval to the newest tests: CT colonography, an X-ray test known as virtual colonoscopy, and a stool DNA test. The panel said more research is needed. > > The task force for the first time did endorse three tests and said everyone age 50 to 75 should get screened with one of them: > > _ a colonoscopy of the entire colon every 10 years > > _ a sigmoidoscopy of the lower colon every 5 years, > combined with a stool blood test every 3 years > > _ a stool blood test every year > > After reviewing research on the tests, the government-appointed panel of independent medical experts concluded that the benefits of detecting and treating colon cancer decline after age 75 and the risks rise. Colonoscopy complications can include infection, perforated colon and reactions to sedatives. > > Doctors may decide to continue screening those between 76 and 85 because of the patient's medical history and risk factors but there's very little reason to routinely test anyone older than 85, according to the guidelines published in Tuesday's Annals of Internal Medicine. > > "The risks of screening at that age are too great to justify any possible benefit," said Dr. Michael LeFevre, a task force member from the University of Missouri School of Medicine. > > The new advice updates 2002 guidelines that did not give an age limit for screening. > > The task force in August said men over 75 should not be screened for prostate cancer; it didn't recommend for or against prostate screening of men under 75. > > Colon cancer is the country's 2nd leading cancer killer. > > Nearly 50,000 Americans are expected to die of colorectal cancer this year. > > Screening to spot early cancer or precancerous growths has resulted in fewer deaths over the last two decades. > > Colonoscopy is considered the gold standard but it is not perfect. > > A long, thin tube with a small video camera is snaked through the large intestine to view the lining and any growths are removed. > > The task force's stance on CT colonography and the stool DNA test is contrary to recent recommendations from the American Cancer Society, as well as radiology and gastroenterology groups that say the newer tests are effective and could encourage people scared of colonoscopies to get checked out. > > Only about half of those who need screening have it done. > > The stool DNA test "has potential but it's an evolving technology," LeFevre said. "It's also likely to have a very high cost." > > Also in Tuesday's journal are the results of a study that found a newer version of the DNA test was better than an older version or a stool blood test in finding cases of cancer. > > For virtual colonoscopy, the task force expressed concerns about radiation exposure a patient would receive every 5 years from it, but acknowledged that the level is relatively low compared to other kinds of X-rays. > > They also worry that it will pick up blips inside and outside the colon that end up being nothing, but lead to more follow-up tests. > > A member of the American College of Radiology Colon Cancer Committee said it was "surprising and unfortunate that such a well respected group would not come out and endorse CT colonography." > > "The science is behind us that it works and it works well," said Dr. Judy Yee of the University of California, San Francisco, who has been involved in virtual colonoscopy research. "The goal is to get more Americans screened, and this is counterproductive to that goal." > > The task force's guidelines could affect whether insurers and Medicare decide to pay for the test, Yee said. > > The cost of virtual colonoscopy can vary widely but it's generally much cheaper than a traditional colonoscopy, which can run several thousand dollars. > > If growths are found in a virtual colonoscopy, a traditional colonoscopy is need to remove them. > > The task force will review its recommendations in 5 years and may make changes if more research emerges, LeFevre said. > > ___ > > On the Net: > > Annals of Internal Medicine:http://www.annals.org/ > ___ Blue Wave/QWK v2.12 This is just a proposal about the general population. But an individual patient is not the general population. So your doctor is always going to have to see how such general recommendations apply to you. In my case, I have a family history of colon cancer, so I suspect my doctors will continue colonoscopies every 5 years at least unti I'm 85, and if I'm still alive perhaps beyond that.
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