Polyps warrant follow-up screening
Dear Dr. Roach: Iama 73-year-old male. This year, I had a colonoscopy. They found some small polyps and one larger polyp. All polyps tested negative for cancer.
I have had two previous colonoscopies in the past 10 years. Polyps were found in each one.
My gastroenterologist said I should have another colonoscopy in one year. There has been no colon cancer in my family.
As you age, is it safe to continue with a colonoscopy? I don’t feel safe having a colonoscopy every year. At what age should seniors stop having a colonoscopy? My previous gastroenterologist told me to have one in five years. I do a stool test yearly, given by my primary doctor.
F.Q.
Answer: I read your reports, which showed a total of nine polyps, all “sessile” (flat, which is higher risk for development into cancer than those with a stalk), the largest being 8 mm.
The pathology report confirmed these as tubular adenomas, none of which had the worrisome finding of high-grade dysplasia.
The official guidelines of the American College of Gastroenterology would recommend a follow-up colonoscopy in three years.
I definitely agree with that in people who are otherwise healthy.
Colon cancer does definitely run in families, but at least 80% of colon cancer occurs in people with no known family history, meaning you can’t be complacent even if there isn’t any history in your family.
There is no absolute age cut-off for screening colonoscopies: Age 75 might be reasonable in someone who really doesn’t want to have another and whose previous results have all been normal, but I would be very unlikely to recommend a screening exam in a person older than 85.
People who have serious medical conditions outside the intestinal tract get less benefit from screening. Age 73 is not so old that I would recommend against screening in otherwise healthy people, and given that you have had eight polyps, I would definitely recommend a three-year follow-up.
I don’t know why the gastroenterologist said one year, based on the reports you sent me.