Aging out of colonoscopy

[plsprius]

Lots of people don't want to accept the risks of a colonoscopy (anesthesia, perforation, fear of the procedure, costs, etc.). And, those risks are higher the older you get.

So, I wonder why more of those people just don't do an annual FIT test (or CologuardPlus test). Medicare pays for these, but you can also buy the test over the counter for practically nothing. It's a standard screening method outside the United States.

The best colon cancer screening method is the one that gets done.

 

[Teacher Terry]

Lots of people don't want to accept the risks of a colonoscopy (anesthesia, perforation, fear of the procedure, costs, etc.). And, those risks are higher the older you get.

So, I wonder why more of those people just don't do an annual FIT test (or CologuardPlus test). Medicare pays for these, but you can also buy the test over the counter for practically nothing. It's a standard screening method outside the United States.

The best colon cancer screening method is the one that gets done.

If you have hemorrhoids you can often get a false positive on a stool test because of trace amounts of blood from them.

 

[Gotadimple]

Lots of people don't want to accept the risks of a colonoscopy (anesthesia, perforation, fear of the procedure, costs, etc.). And, those risks are higher the older you get.

The FIT test can give false positives. When that happens then you're on to the colonoscopy. My next one is in 3 weeks.

But there is good news and bad news. The good news is that Medicare changed the rules and it will no longer pay for a colonoscopy after age 75 according to my gastroenterologist. The bad news is that if you have a history of polyps they will pay for it through age 85.

 

[Peter]

Do any of these non-colonoscopy tests detect non cancerous polyps?

 

[EastWest Gal]

My husband had his colonoscopy last year at the age of 76, after not having had one in more than 20 years. His doctor found 7 polyps, incluing a large one but all benign. His doctor asked him to have another one in 5 years' time. Prior to going in for his colonoscopy, Cologuard came back positive for further screening through colonoscopy.

We figure he will have a Cologuard in 5 years' time and depending on the results and his health then, we will make a decision as to whether to proceed with another colonoscopy.

Cologuard is recommended every three years for people with average risk. You may want to discuss this with his doctor.

 

[RetiredHappy]

Cologuard is recommended every three years for people with average risk. You may want to discuss this with his doctor.

We are aware of that. We have been using Cologuard every three years.

 

[Act2]

Dad had reached his “last” colonoscopy in his late 70’s, then a scan for another condition seemed to indicate colon cancer by something seen on the periphery of the scan, so he had another colonoscopy at that point (mid-80’s). To our great relief and surprise, the colonoscopy confirmed that he did NOT have colon cancer.

 

[hesperus]

I am 75 and just had a colonoscopy that found one small polyp. The previous 2 or 3 colonoscopies found 2 small polyps each which were adenomas (potentially precancerous).
I told doc that women in my family live into their early 90's, which I can reasonably expect to do as well. Hopefully even longer, if health remains acceptable. I am in reasonably good health right now.

Doc advised me that in the absence of GI symptoms going forward, I could consider this my last colonoscopy, and not to bother with stool tests in future either. I guess she considers me low risk for colon cancer although the time since the previous procedure and this one was 5 years as recommended. Not sure if I want to follow this advice to discontinue future surveillance or not. I would gladly be done with the procedure, but don't want to spend my last years in misery with active colon cancer.

Was wondering what has been the experience of other members here regarding discontinuing colonoscopies?

this is one of those where age + overall health matters more than a fixed rule… a lot of guidelines taper off screening around mid 70s to 80 if life expectancy is limited or risks from the procedure go up, but you’ve had adenomas before, so you’re not exactly “zero risk” either, that’s why your doc is weighing benefit vs hassle now… honestly comes down to how you feel about it, if you’re in good shape and don’t mind the prep, some people keep going every 5 years for peace of mind, others stop and accept the trade off, neither is crazy, just make sure it’s a shared decision with your doc based on your actual health, not just age

 

[Koolau]

I'm due next year for a 3-year followup colonoscopy (due to polyps/adenomas - 2 colonoscopies in a row). I'll be 80. Assuming no other major health changes, I'll "go for it" despite the added age risk.

I've seen too many people die from colon cancer. Better to chance a perforation or other issue from colonoscopy in my opinion but YMMV.

 

[Mark1]

Based on the data I found below, I would be very comfortable going until early 80s for sure.

DW recently increased her interval from 5 to 6 years to "split the difference" such that her last colonoscopy would be at 75 years of age. PCP was OK with increase, and the plan, with the exception of 75 being the last one.

Age Group	Perforation Rate (per 10,000)	Relative Increase
50–74 years	~4 to 6	Baseline
75–80 years	~8 to 10	2x increase
81–85 years	~15 to 20	3x to 4x increase
Over 85 years	~37	~6x to 9x increase

* Source of data unknown, only AI knows for sure.

 

[Teacher Terry]

Based on the data I found below, I would be very comfortable going until early 80s for sure.

DW recently increased her interval from 5 to 6 years to "split the difference" such that her last colonoscopy would be at 75 years of age. PCP was OK with increase, and the plan, with the exception of 75 being the last one.

Age Group	Perforation Rate (per 10,000)	Relative Increase
50–74 years	~4 to 6	Baseline
75–80 years	~8 to 10	2x increase
81–85 years	~15 to 20	3x to 4x increase
Over 85 years	~37	~6x to 9x increase

* Source of data unknown, only AI knows for sure.

I’m doing something similar to your wife. I was supposed to get another colonoscopy at three years which was a year ago. I’m going to wait one more year to have it and then I will be almost 73 and that will be my last one.

 

[Turbo29]

I had one at 52 where two polyps were found and removed. Was told to come back in 5yr, which I did, no polyps. Told to come back again in 5yr and that colonoscopy found no polyps so they told me to wait 10yr before the next one. I was fine with that (because who loves colonoscopies) but now, after reading this thread, I am left wondering about the 10yr gap given that I did have polyps in the past.

In any case, I am due for my next one about a year from now, which should be the last.

 

[Buckeye]

I had one at 52 where two polyps were found and removed. Was told to come back in 5yr, which I did, no polyps. Told to come back again in 5yr and that colonoscopy found no polyps so they told me to wait 10yr before the next one. I was fine with that (because who loves colonoscopies) but now, after reading this thread, I am left wondering about the 10yr gap given that I did have polyps in the past.

In any case, I am due for my next one about a year from now, which should be the last.

I'll be doing FIT or Cologuard every year, polyps or no polyps, colonoscopy or no colonoscopy.

 

[PatrickA5]

Going for my first colonoscopy this morning (age 67). Had a positive Cologuard test a couple of months ago. I have done annual stool tests over the last 10 years and always negative. Probably pressed my luck by not having a colonoscopy until now.

 

[Koolau]

Going for my first colonoscopy this morning (age 67). Had a positive Cologuard test a couple of months ago. I have done annual stool tests over the last 10 years and always negative. Probably pressed my luck by not having a colonoscopy until now.

Hoping for good results. Be sure to let us know, please.

 

[Buckeye]

Going for my first colonoscopy this morning (age 67). Had a positive Cologuard test a couple of months ago. I have done annual stool tests over the last 10 years and always negative. Probably pressed my luck by not having a colonoscopy until now.

My husband had his first colonoscopy at 75. He takes a FIT every year and December 2024's test (which we asked his VA doc to repeat) came back positive for blood. He had 2 polyps removed (the one in the corner of the colon was probably the bleeder). Nothing dangerous found according to the report. Come back in 3 years. He will continue with FIT every year which I had to argue hard for with his VA doc. Seems like a very prudent thing to do. Also, cheap and non-invasive.

 

[PatrickA5]

Colonoscopy came out great. Dr. said it was super clean with no polyps and to come back in 10 years. So, another false positive Cologuard test. Still, I'm glad I had it just to be sure.

 

[Koolau]

Colonoscopy came out great. Dr. said it was super clean with no polyps and to come back in 10 years. So, another false positive Cologuard test. Still, I'm glad I had it just to be sure.

 

[Walt34]

I just had this discussion yesterday with my gastroenterologist. I'm 76 now, next year I will be "due" for another colonoscopy. It's up to me of course but I'm in relatively good health now and if there are no significant changes I'll probably go with having the colonoscopy. But the doc has been around the block more than once and I think knows when to quit during a procedure.

 

[Buckeye]

Colonoscopy came out great. Dr. said it was super clean with no polyps and to come back in 10 years. So, another false positive Cologuard test. Still, I'm glad I had it just to be sure.

That's great news! Will you still do an annual Cologuard or FIT? I will always do an annual test because I had a friend who always did her routine colonoscopies but they found Stage 4 cancer during one. Would she be alive if she'd been doing an annual Cologuard or FIT instead of not checking for 5-10 years?

 

[PatrickA5]

That's great news! Will you still do an annual Cologuard or FIT? I will always do an annual test because I had a friend who always did her routine colonoscopies but they found Stage 4 cancer during one. Would she be alive if she'd been doing an annual Cologuard or FIT instead of not checking for 5-10 years?

I won't do another Cologuard for a few years since this last one came back false positive. I'll ask my PCP if I should do FIT next year at my annual appointment.

 

[plsprius]

You might not know, but Cologuard (and the newer Cologuard Plus for those on Medicare) both include a FIT test as part of the overall test. You get both the FIT and the DNA test at the same time, but they do not breakout how the results from the two methods are combined to give you a positive/negative result. I'm guessing a positive by either result in a positive overall.

From the web:

Cologuard is a FIT-DNA test (often called sDNA-FIT) that combines a fecal immunochemical test (FIT) with a DNA-based test to detect blood and altered DNA in stool. It checks for blood using antibodies (the FIT component) alongside biomarkers for cancer. It is a comprehensive, multi-target stool DNA test performed every 3 years.