8. Follow-up ultrasounds for small ovarian cysts
Many women receive repeated ultrasounds to verify that ovarian cysts have not become cancerous, but current research says that these tests aren't necessary. For one thing, premenopausal women have harmless ovarian cysts regularly. For another, about 20 percent of postmenopausal women also develop harmless cysts.
"The likelihood of these small simple cysts ever becoming cancer is exceedingly low," says Deborah Levine, chair of the American College of Radiology Commission on Ultrasound and a professor of radiology at Harvard Medical School.
In postmenopausal women, only cysts larger than 1 centimeter in diameter need a follow-up ultrasound. For premenopausal women, who typically have benign cysts every month when they ovulate, cysts smaller than 3 centimeters aren't even worth mentioning in the radiologist's report, says Levine.
9. Colonoscopy after age 75
Most people should have screening for colon cancer at 50 and then every five to 10 years after that, if the first test is normal. By age 75 — if you've always had normal colonoscopies — you can stop taking this test altogether. That should be good news, because a colonoscopy can cause serious complications in older people.
"Just the preparation for colonoscopy can be exceptionally harsh," says James Goodwin, director of the Sealy Center on Aging at University of Texas Medical Branch, who studies overuse of colonoscopies. Some patients become incontinent or experience weeks of pain, diarrhea and constipation. In worst cases, the procedure can perforate the colon. Despite such risks, recent studies have found that substantial numbers of people over 75, even over 85, are still getting screening colonoscopies.
To protect your colon, eat plenty of fruits, vegetables and whole grains for fiber. Cut down on fatty foods, red meat and processed meats. Lose weight if you're overweight and exercise. Sound familiar? It should, because that's the best advice for protecting the rest of your body — and mind — as well.
10. Yearly physical
There's little evidence that having an annual checkup can keep you healthy. Many tests that doctors regularly perform — to diagnose anemia, liver disease or urinary tract infections, for example — don't make sense unless there's a reason to suspect a problem. "A healthy 52-year-old does not need to see the doctor once a year," says Jeremy Sussman, an internist for the VA system and assistant professor at the University of Michigan who was on the Society of General Internal Medicine task force for making the Choosing Wisely recommendation.
"We certainly don't think people should never see doctors — quite the opposite. We question the value of seeing someone for the sake of seeing someone." Your specific needs should determine how often you see your doctor, he adds. If you have an illness that needs treatment, you should see your physician. And do talk to your doctor about how often you need to have your blood pressure and cholesterol tested. "Our real point is, don't do these things for the sake of a calendar," he says. "Do them for the sake of your health."
Elizabeth Agnvall is a writer and features editor for AARP Media.
THE HIGH COST OF OVERTESTING
Each year in the United States, an estimated $225 billion is wasted on unnecessary medical tests and services, according to Rosemary Gibson, coauthor of The Treatment Trap.
Consider that nearly two-thirds of women who have had hysterectomies and half of women over 65 with no cervical cancer history — 14 million women — report having recent Pap tests, even though the American College of Obstetricians and Gynecologists recommends against them for these women.
An estimated $3 billion is spent on PSA screening for prostate cancer, which many doctors groups say does more harm than good. Nearly a fourth of $1,000 colonoscopies performed in older people are most likely inappropriate.
That's just the cost of the tests. Add in the amount spent on additional unnecessary biopsies, surgery and other procedures and the amounts are staggering.
MRI scans and other imaging tests for lower back pain are notoriously misleading. Yet those tests lead to more than $80 billion a year in treatments — painkillers, surgery and spinal injections — that often don't fix the problem. PSA screening leads to an estimated $12 billion a year in prostate cancer care, including radiation biopsies and prostatectomies — much of it unnecessary.