Roughly 25% of screening colonoscopies done among the elderly may be inappropriate, according to a JAMA Internal Medicine study of Medicare data.

Researchers examined claims data on some 75,000 Texas Medicare recipients aged 70 or older who underwent complete colonoscopy in a 1-year period starting in 2008. Procedures that were repeated early without a clear indication, or those that were done contrary to published guidelines with regard to age, were considered possibly inappropriate. In addition, a 5% national Medicare sample was also examined.

Overall, 23.4% of the cohort were found to have undergone a potentially inappropriate procedure. There was marked variation geographically both within Texas and the U.S., as well as among colonoscopists, some of whom had rates of potentially inappropriate colonoscopies above 45% (they tended to be surgeons and graduates of U.S. medical schools).

Source: JAMA