As lifespans get longer, we find that some of the medical principles that we have relied on are less important. We also know that some individuals are healthier than other individuals at every age. That results in changes in what we do medically.

The best example of that is related to colonoscopies. Screening colonoscopies are recommended for adults between the ages of 45 and 75 every 10 years. If the screening test is abnormal (for example, polyps are found), tests are done more frequently.

Between 75 and 85, the recommendations change. They are based more upon the health of the individual rather than the actual age.

Some people might have issues with the bowel prep itself. They may become dehydrated. That might result in a fall. Some people have too many other medical problems to go through the test itself. The intestinal wall also gets thinner with age. That leads to an increased risk of bowel perforation. Therefore, individuals in this age range may or may not be candidates for additional screening.

Once an individual reaches age 85, screening is usually discontinued. The risks may actually outweigh any benefits.

Some cancers grow very slowly. For that reason, screening tests might show cancer. However, it may not grow fast enough to be a problem depending on the individual’s age. Finding a cancer may result in a treatment plan that might be more harmful to the patient than the cancer itself.

PAP smears represent one example. Cervical cancer grows slowly. In addition, a woman who has had multiple negative tests in the past, has a lower likelihood of having a positive test at a later age. These reasons lead to fewer PAP smears after age 65.

Mammograms also fall into this category. Finding a small, slow growing tumor after age 75 often has more complications from the treatment than the cancer will ultimately cause.

For men, the same applies to PSA tests. Prostate cancer is often very slow growing. Abnormal PSA tests can lead to invasive biopsies and complications from those biopsies. Therefore, tests tend to no longer be followed after age 70 to 75.

CT scans are recommended for individuals with a heavy smoking history. This screening can be stopped after an individual has quit smoking for more than 15 years. It can be stopped if an individual has health issues that would make them ineligible for lung cancer treatment. It also can be stopped at age 80.

Earlier this month, a related study was published in France. They looked at individuals over age 75 that were taking statin medications for high cholesterol. Some of the patients continued taking their normal dose of medication. The other group stopped their medication. They further divided the groups into those with a history of heart related problems and those without such a history.

They followed both groups for 36 months. For the small group that they followed (1,160 patients), there were no real differences in results. Mortality rates were similar. Cardiac complications were similar. Cardiac deaths were similar. They concluded that after 75 years of age statins did not have a major effect on preventing cardiac deaths.

Their findings are preliminary because of the small numbers. However, there may be more than just screening procedures that can be stopped at advanced ages. We clearly have more to learn about how aging can change our medical practices.