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Clinical Crossroads | Clinician's Corner

A 71-Year-Old Woman Contemplating a Screening Colonoscopy

William C. Taylor, MD, Discussant
JAMA. 2006;295(10):1161-1167. doi:10.1001/jama.295.10.1161.
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DR BURNS: Ms G is a 71-year-old woman with a past medical history of osteoporosis, mitral valve prolapse, mild rheumatoid arthritis, and hypothyroidism. She has Medicare. Ms G is trying to decide whether to undergo a colonoscopy to screen for colon cancer.

Ms G is currently feeling well and has no active medical issues. Ms G's physician has encouraged her to have a colonoscopy, but she remains reluctant to proceed for 3 reasons. First, she has had adverse reactions to anesthetic agents in the past and is concerned about a potential reaction to the agents that would be used for a colonoscopy. Second, she is concerned about needing transportation home after receiving a sedative because her husband has driving restrictions. Third, she is unsure about the importance of colonoscopy given her negative family history of colon cancer. In addition, she expressed a concern about the size of colonoscopes designed for adults. Of note, she has completed home-based fecal occult blood testing (FOBT) on a yearly to every-other-year basis, and test results have always been negative. She has never undergone flexible sigmoidoscopy.

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