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Study: Colon cancer screening helps some over 75

By WTOP Staff

LAURAN NEERGAARD
AP Medical Writer

WASHINGTON (AP) — How old is too old for a colonoscopy? A surprising number of people older than 75 haven’t ever been screened for colon cancer — and researchers reported Monday that it’s not too late for them to get caught up.

Some may even consider screening into their 80s.

Colon cancer screening is powerful, credited not only with saving lives. The American Cancer Society recently calculated that over the last decade, new cases of colon cancer dropped significantly among middle-aged and older adults, thanks largely to increasing use of colonoscopies that allow removal of precancerous growths before tumors have time to form.

Some things to know about the latest research on colon cancer screening.

WHO SHOULD BE SCREENED?

National guidelines recommend regular checks starting at age 50 and going up to age 75. Nearly two-thirds have been appropriately screened for colon cancer, according to the latest government estimates.

WHAT ABOUT OLDER AMERICANS?

Those guidelines don’t recommend routine screening after age 75. After all, a colonoscopy that delivers good news isn’t supposed to be repeated for 10 years, because it takes so long for those precancerous polyps to become dangerous. Average life expectancy for an 80-year-old is eight to 10 years.

But the guidelines don’t address the 23 percent of Americans over 75 who somehow missed out on screenings when they were a bit younger, before a colon check in your 50s and 60s had become the norm.

Monday’s study examines if it’s worth starting screening so late, when most people already have at least a few other health problems, such as heart disease, that could affect whether detecting an early-stage colon cancer prolongs life.

THE FINDINGS

Researchers at Erasmus University in the Netherlands and New York’s Memorial Sloan Kettering Cancer Center used computer modeling to compare the potential effects of different colon checks on 10 million previously unscreened people ages 76 to 90.

Someone who’s very healthy should consider some form of screening up to age 86 — but even a person with severe health problems could benefit from a first-time check up to age 80, the team reported in Annals of Internal Medicine.

In the healthiest patients, a colonoscopy was the most effective choice up to age 83, while a stool test was the better choice for 85- and 86-year-olds, the researchers found.

The results are a bit surprising, said Dr. Richard C. Wender, the American Cancer Society’s chief of cancer control.

“Our sense was, if we’re going to screen beyond age 75, it should only be in very healthy people,” said Wender, who wasn’t part of the new study. “This model I think will help us give clearer advice to the public.”

THE BIGGER MESSAGE

About 137,000 Americans will be diagnosed with colorectal cancer this year, the cancer society estimates. About 50,000 colon cancer patients will die.

Upper age limits aside, public health officials say not enough of the 50-and-older crowd get potentially life-saving checks. The cancer society’s new campaign aims for a screening rate of 80 percent, up from two-thirds, by 2018.

“If you’re polyp-free at 70, we have so dramatically reduced your likelihood of a death from colon cancer, you probably don’t need to ever think about it again,” Wender said.

THE CHOICES

With a colonoscopy, doctors use a long flexible tube to examine the colon and remove any polyps. While only needed once a decade, it can be uncomfortable and is the priciest option.

Studies show a home stool test done every year can be equally effective. (A third choice, sigmoidoscopy, uses a tube to examine the lower colon but isn’t common in the U.S.)

In the new study, stool testing was a better value for the oldest patients because it targets larger polyps “that have a shorter period of time before they become a real threat,” Wender explained.

But individual choice matters: “There’s a test out there for everybody,” he said.

Copyright 2014 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Don’t Settle for Student Loans to Pay for Online Education

By WTOP Staff
Online college programs are becoming a more popular choice for prospective students, with one study finding that more than 6 million students enrolled in at least one online course in fall 2015. The popularity of these courses can be attributed in part to their flexibility with working adults' schedules, students' ability to progress more quickly through online programs and, oftentimes, cheaper tuition. [See 10 low-cost online bachelor's programs for out-of-state students.]Online degrees can be beneficial to many college students, but some studies have shown online learners complete their programs at lower rates than students at traditional brick-and-mortar campuses. Individuals with student loans but no degree comprise two-thirds of defaulted borrowers. Though these numbers are not encouraging, just like for traditional programs, there are ways to reduce how much you'll need to borrow for an online program to ensure you won't become one of these statistics. Don't just settle on borrowing student loans to cover the whole cost of your program and living expenses. Instead, start thinking about how to cut costs and cover your balance in different ways, such as the following. -- Grants and scholarships: Even though you are taking an online course, you can still apply and receive grants and scholarships. But your first step should be to complete the Free Application for Federal Student Aid, commonly referred to as the FAFSA, which will allow you to receive a Pell Grant if your expected family contribution is low enough. The EFC criteria and award amounts are adjusted annually, but the 2017-2018 academic year awards range from $606 to $5,920, which could significantly lower the amount you borrow annually. Your next step is to apply for scholarships. You can start by checking online scholarship search engines, such as the Salt Scholarship Search, College Board's BigFuture and Peterson's. But don't forget to take advantage of local organizations and your school's financial aid office. Both may offer scholarships that you can't find with a national scholarship search. [Review these 10 sites to kick off your scholarship search.]For instance, organizations like the Elks Club, Knights of Columbus or the Rotary Club typically offer scholarships annually to local students. Just because you're going to school online doesn't mean you're ineligible. Visit your local library for scholarship listings, and ask around town. You might be surprised how many local organizations offer scholarships. While these scholarships typically aren't large, every little bit counts. Each dollar you receive in a scholarship is a dollar you don't have to borrow and pay interest on. -- Work-study: Another option for online students may be work-study awards. Not all students enrolled in online programs are eligible, but students at some schools -- including, for example, SUNY Empire State College and Liberty University -- are. Work-study awards are not given upfront like scholarships and grants. In most cases, they are an offer to earn up to the awarded amount if you secure an eligible work-study job. While there is a misconception that all work-study jobs must be on campus, students can work for off-campus, nonprofit or public employers as long as the work is in the public's interest. You may be able to work for a for-profit employer if the job is relevant to your course of study. No matter who the outside employer is, it will need to have an established agreement with your college for you to receive work-study funds. Remember, to be eligible for federal financial aid, you must be enrolled and pursuing a degree or certificate. If you're not working toward a credential, Pell Grants and work-study won't be option, but you may still be able to take advantage of private scholarships -- just be sure to read the eligibility criteria carefully. [Explore what to know about financial aid in online programs.]-- Pay as you go: One of the great benefits to enrolling online is the flexible schedule, which can allow you to complete your college coursework around your responsibilities. But prospective students often overlook using their part- or full-time job earnings as an option for paying for college. Almost 80 percent of college students in 2015 worked at least part time while attending classes, according to the National Center for Education Statistics. By budgeting and thinking strategically about your college costs, you can likely reduce your dependence on student loans by paying a portion out of pocket. Many -- but not all -- online programs are less expensive than traditional programs and often have shorter payment periods. Six, eight or 10 weeks are common course durations. Because of the frequency of payments in an online setting, you may be well-placed to pay as you go and possibly avoid borrowing altogether. Attending college online and avoiding student loans may be challenging, but if you are willing to put in the effort, you can limit the amount you need to borrow. More from U.S. News Q&A: Understanding Student Loan Discharge Eligibility Student Loan Refinancing Isn't Right for All Borrowers
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