Colonoscopy is valid for 70-year-old

Dear Dr Roach: I am a 70-year-old man in good health. I have had regular colonoscopies since my 50s, but I wonder about the wisdom of a colonoscopy at my age. My doctor has sent repeated requests for me to schedule the procedure. Is this a valid exam at my age?

R.R.

Answer: The guidelines and the clinical studies are clear: Screening for colon cancer saves lives. A colonoscopy (or other screening test) is recommended beginning at age 45, and continuing, on average, until age 75, so long as a person is in good health. Some people want to continue colon cancer screening even after 75, but there are no good studies to support use after age 75. I would not recommend a test past age 85, since the benefits are lower and the risks are higher in patients who are that old.

Dear Dr. Roach: In 2018, I had a stroke followed by an extreme itch across my back where a bra strap would be. In the beginning of the pandemic, I wore the N95 mask with the rubber across the back of my neck for just a short time, now my neck itches, too. I was told recently during a home visit that I should try gabapentin. Do you think that gabapentin would work to help stop my itch?

S.G.M.

Answer: Neuropathic itching is the term used for an itch after nerve damage, such as after a stroke, but it can also occur after localized nerve damage such as shingles. The process is similar to pain that follows nerve damage.

Your itching on the neck may simply be an allergic response to the elastic in the mask strap. A mild steroid cream may help the neck, but most anti-itch remedies are not helpful for neuropathic itching.

The most effective treatment has been local anesthetics. For a distinct or defined area, a lidocaine patch can be extraordinarily effective.

There are reports of effectiveness from gabapentin and its “cousin,” pregabalin, so it may be worth a try if the lidocaine patch doesn’t work for you. A neurologist or pain management expert should have expertise in managing neuropathic pain and itching.