Entries in Colonoscopies (4)


Five Medical Tests You May Not Need

Keith Brofsky/Thinkstock(NEW YORK) -- A routine visit to the doctor's office can bring up a laundry list of medical tests, all designed to screen for one serious disease or another.  But according to a new report from leading physician groups, a large number of medical tests and procedures billed as routine are largely unnecessary.

For many patients and doctors, it's easy to adopt the notion that if a little screening is good, more of it is better, "just to be sure" nothing is wrong.  But that approach is costly, both in terms of health care dollars spent and the potential risks of the screenings.

"There's no medical treatment or test that is 100 percent without risk," said Dr. Christine Cassel, president and chief executive officer of the American Board of Internal Medicine Foundation.  "Things that you might think are routine actually should not be done because they expose patients to risk."

To help patients parse through the barrage of medical procedures, the ABIM Foundation and Consumer Reports have created the Choosing Wisely project, a campaign that asked nine physician groups to identify five tests or procedures in their fields that are over used or unnecessary.

Cassel said the project is designed to give patients as much information as doctors have about screening, as well as to rein in health care costs.

The full list was published on Wednesday, but here's a look at five common tests you may not need:

Cardiac Stress Test

Cardiac stress tests were once considered a staple of routine check-ups.  Also called the treadmill test or an exercise EKG, doctors often use it to determine if a patient has blocked arteries.  The U.S. Preventive Services Task Force has long recommended that people at low risk for cardiovascular disease and with no symptoms of heart trouble don't need an annual stress test.  But a 2010 Consumer Reports survey of 8,000 people ages 40 to 60 found that 44 percent of low-risk people with no symptoms had been screened.

According to the American College of Cardiology, stress tests should only be performed on patients who have peripheral artery disease, diabetics over age 40 and people who have an increased risk of coronary artery disease.

Chest X-rays Before Minor Surgery

For many years, chest x-rays were another nuts-and-bolts part of hospital care.  But the test is going by the wayside.  The American College of Radiology said for most patients undergoing outpatient procedures, the tests are unnecessary. 

Some people should get a chest x-ray before going under the knife, such as those with a history of heart problems, lung disease or cancer.  For others with a normal physical exam, the ACR said the test leads to a change in patient care in only two percent of cases.

Imaging Tests for Lower Back Pain

According to the American Academy of Family Physicians, lower back pain is the fifth most common reason for all visits to the doctor's office.  But unless a patient has certain red flags of a deeper physical problem, such as spinal abnormalities or neurological problems, the AAFP and the American College of Physicians say doctors shouldn't use MRIs, CT scans or other imaging to investigate lower back pain.

Frequent Colon Cancer Screenings

Colonoscopies, perhaps the most unloved cancer screening, are a necessary aspect of health care after age 50.  A recent study found that having precancerous growths spotted on colonoscopies removed cut the death rate from colon cancer by 53 percent. 

Most major medical groups recommend that people over 50 get a colonoscopy every 10 years.  However, the key is moderation.  According to the American Gastroenterological Association, most adults who are at an average risk of colon cancer and who get a clean bill of health from a colonoscopy don't need another one for the next decade -- good news for health care pocketbooks, since the test costs an average of $1,050.

Bone Density Scans

Osteoporosis becomes a real risk for people, particularly women, with increasing age.  The National Institutes of Health estimates that one in five women over age 50 has osteoporosis.  But patients may want to ask their doctors how often they need a bone density scan to screen for signs of the disease.

The American Academy of Family Physicians echoes the U.S. Preventive Services Task Force in recommending that only women over age 65 get a bone mineral density test, called dual-energy x-ray absorptiometry, or a DEXA scan.  The AAFP also recommends the test for men age 70 and older, although the USPSTF said there is insufficient evidence to balance the risks and benefits of screening men for osteoporosis. 

The test costs more than $100, and unless a woman under age 65 has additional risk factors, such as smoking, an eating disorder or previous broken bones, doctors say the scan is unnecessary.´╗┐

Copyright 2012 ABC News Radio


Could Mozart Decrease Your Risk of Colon Cancer?

Stockbyte/Thinkstock(HOUSTON) -- Doctors were more likely to detect precancerous polyps during colonoscopies if they had Mozart playing in the background, a small study found.

It only included two doctors, but for one, listening to Mozart more than tripled the polyp detection rate from 21.25 percent to 66.7 percent, researchers from the University of Texas Health Science Center at Houston reported Monday at the American College of Gastroenterology's annual meeting. Undetected, the polyps -- called adenomas -- can become cancerous.

“Anything we can do get those rates up has the potential to save lives,” study author Dr. Catherine Noelle O’Shea said in a statement. “While this is a small study, the results highlight how thinking outside the box -- in this case using Mozart -- to improve adenoma detection rates can potentially prove valuable to physicians and patients.”

The polyp detection rate for the other doctor studies rose from 27.16 percent to 36.7 percent.

The study adds weight to the “Mozart effect” -- the long-standing observation that listening to music can lead to a short-term improvement on some mental tasks. Some experts attribute the performance boost to a more positive mood or increased arousal. Others say complex music triggers a response in the brain that makes it better equipped to tackle an additional task.

Untreated, adenomas can lead to invasive colorectal cancer -- the third most common cancer diagnosed in men and women in the U.S. and the second leading cause of cancer death in both sexes combined, according to the American Cancer Society. But when detected early, adenomas can be removed.

The U.S. Preventive Services Task Force recommends routine screening for colorectal cancer using fecal occult blood testing, sigmoidoscopy and colonoscopy in men and women aged 50 to 75.

To reduce the risk of colorectal cancer, the American Cancer Society recommends maintaining a healthy weight and an active lifestyle, eating a healthy diet high in fruits, vegetables and grains, and low in red meats -- and moderate consumption of alcohol.

Copyright 2011 ABC News Radio


Colorectal Cancer Death Rates Vary across the US

Comstock/Thinkstock(ATLANTA) -- Despite a steady drop in the number of deaths from colorectal cancer,  particularly over the past decade, a new study released Thursday shows that the decrease may not be happening equally across the country.

Colorectal cancer is the second-leading cancer killer in the U.S. Researchers at the American Cancer Society reviewed mortality data from 1990 to 2007 across the U.S. and found that reductions in mortality ranged from 9 percent in Alabama to more than 33 percent in Massachusetts. Futhermore, states like Mississippi and Wyoming showed no decrease at all.

So what's behind the disparity?

The authors of the study, published in Cancer Epidemiology, Biomarkers & Prevention, found that there is a strong correlation between higher rates of screening for colorectal cancer and higher reductions in mortality rates.

They speculate that economic disparity may be playing a role since 18.8 percent of people in Mississippi don’t have health insurance compared with 5.4 percent in Massachusetts, and this lack of coverage may limit their ability to get the recommended colonoscopies.

Copyright 2011 ABC News radio


Report: Some Patients Get Colonoscopies Too Often

Siri Stafford/Photodisc(WASHINGTON, D.C.) -- A new study finds that some patients get colonoscopies more often than they should.

In a report issued Monday in Archives of Internal Medicine, researchers urge doctors to be more discerning about advising colonoscopies. This means following established guidelines in the United States for potential victims of colorectal cancer. Current guidelines recommend middle-aged and older adults to have a colonoscopy every 10 years. Colon cancer usually grows slowly, so more numerous examinations are unnecessary.

Colonoscopies, moreover, are invasive procedures that carry a variety of risks and complications. A less invasive procedure involving stool tests should be done once a year, and allows doctors to catch the cancer in its developing stages.

Copyright 2011 ABC News Radio´╗┐

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