Dear Dr. Roach: I am a 70-year-old man in good health. I have had regular colonoscopies since my 50s, but I wonder about the wisdom of a colonoscopy at my age. My doctor has sent repeated requests for me to schedule the procedure. Is this a valid exam at my age, or is the clinic taking advantage of my excellent medical insurance? — R.R.

Answer: The guidelines and the clinical studies are clear: Screening for colon cancer saves lives. A colonoscopy (or other screening test) is recommended beginning at age 45, and continuing, on average, until age 75, so long as a person is in good health. Some people want to continue colon cancer screening even after 75, but there are no good studies to support use after age 75. I would not recommend a test past age 85, since the benefits are lower and the risks are higher in patients who are that old.

Although there are unfortunately exceptions, I really believe most doctors recommend treatments to help their patients, not enrich themselves. Our code of ethics instructs us to put our patients’ needs above our own.