Here’s something your doctor probably won’t tell you at your next checkup: A lot of the tests and treatments seniors get routinely don’t help them. Some actively hurt.
I’m not talking about fringe theories or wellness influencer nonsense. I’m talking about recommendations from the U.S. Preventive Services Task Force (USPSTF), the American Geriatrics Society, and the Choosing Wisely campaign — the same establishment doctors quote when they’re trying to sell you something else.
Unnecessary medical care isn’t just risky. It’s expensive. The National Academy of Medicine estimates the U.S. wastes about $765 billion a year on care that doesn’t help anyone — and a big chunk of that bill lands on seniors and Medicare.
So before you say yes to the next “routine” test, ask whether you actually need it. Here are seven procedures researchers and major medical groups say many older adults can safely skip.
1. Repeat colonoscopies after age 75
If you’re over 75 and a previous colonoscopy came back clean, another one probably won’t save your life — but it could send you to the ER.
The USPSTF rates colon cancer screening just a C for adults 76 to 85, meaning the benefit is small. The task force flat-out recommends against any screening past 85.
Yet plenty of older patients with limited life expectancy still get told to come back for another one. The New York Times recently reported that, according to a 2023 study, this happens with roughly 60% of them.
The risks add up. A recent study found nearly 7% of patients over 75 had a hospitalization or ER visit within a month of their colonoscopy. The procedure also requires stopping blood thinners — risky if you have stents or atrial fibrillation.
As Dr. Steven Itzkowitz, a gastroenterologist at Mount Sinai’s Icahn School of Medicine, recently told the New York Times about an 85-year-old patient considering another colonoscopy: “I’m saying to myself, ‘What are we accomplishing here?'”
2. Prostate cancer screening after 70
The blood test that’s screened millions of men for prostate cancer? After age 70, the USPSTF recommends against it.
The task force found that for men over 70, the test’s potential harms outweigh its benefits. False positives are common. Biopsies can cause bleeding and infection.
And treatment — surgery or radiation — leaves about 1 in 5 men with long-term urinary incontinence and 2 in 3 with erectile dysfunction. That’s not a tradeoff to take lightly.
Yet prostate-specific antigen (PSA) testing for men over 70 has actually risen in recent years. One reason: Doctors quietly bundle the PSA into routine bloodwork without flagging it. If you’re over 70, ask whether your blood draw includes PSA — and whether you want it to.
3. Mammograms after 75
The USPSTF takes no position on screening mammograms for women over 75 because the evidence is too thin to say they help. The American College of Physicians actively recommends stopping at 75 for average-risk women.
Why? At advanced ages, mammograms increasingly find slow-growing cancers that would never cause symptoms in a woman’s remaining lifetime — but get treated aggressively anyway. That means surgery, radiation, or chemo for a tumor that wasn’t going to kill you, with side effects that very well might.
That doesn’t mean every 78-year-old should skip the test. A healthy woman with a long life expectancy and family history might still benefit. But automatic yearly mammography after 75 is exactly the kind of habit worth questioning.
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4. Pap smears after 65
If you’ve had normal Pap or HPV results over the years, the USPSTF says those “who have had adequate prior screening and are not otherwise at high risk for cervical cancer” can stop cervical cancer screening at 65.
The reason is simple math. Cervical cancer rates peak in middle age and drop sharply after that. Screening women in their late 60s and 70s mostly turns up false positives — leading to anxiety, follow-up biopsies, and unnecessary procedures. The risks outweigh the benefits.
Women who’ve had a hysterectomy that removed the cervix (for non-cancerous reasons) don’t need screening, as long as they “do not have a history of a high-grade precancerous lesion (i.e., cervical intraepithelial neoplasia [CIN] grade 2 or 3) or cervical cancer.” If your doctor recommends one, ask exactly why.
5. Antibiotics for ‘UTIs’ with no symptoms
This one’s a disaster in nursing homes and assisted living. A senior seems confused, agitated, or off — staff orders a urine test, bacteria show up, and antibiotics get prescribed for a urinary tract infection (UTI).
The problem is, bacteria in the urine without symptoms (called asymptomatic bacteriuria) is incredibly common in older adults and usually doesn’t need treatment. The Infectious Diseases Society of America’s clinical guidelines say so directly.
Treating it doesn’t reduce infections or improve survival — but it does breed antibiotic-resistant bacteria and cause side effects like C. difficile diarrhea, a nasty intestinal infection.
One study of older women with recurrent UTIs found 41% of antibiotic prescriptions were unnecessary. If a loved one in a care facility gets prescribed antibiotics, ask: Did they actually have UTI symptoms? Or did someone just see bacteria on a test and react?
6. Removing skin spots
You spent decades in the sun. Now your dermatologist wants to freeze, scrape, or zap every reddish-rough patch on your scalp, hands, and face. Often, you don’t need them all gone.
These spots are called actinic keratoses, and they’re extremely common in older adults. According to the New York Times, one large study of traditional Medicare beneficiaries found that nearly 30% of them were diagnosed with at least one over a five-year period.
They can occasionally progress to skin cancer, but most don’t. Researchers are increasingly questioning whether removing every one of them makes sense for elderly patients with limited life expectancy.
Each removal costs money, can scar, and may need to be repeated. Ask your dermatologist which spots genuinely need attention and which can be watched.
7. Lifetime thyroid medication you might not need
Levothyroxine (brand name Synthroid) is one of the most-prescribed drugs in America, often taken for life. But research suggests many older adults on it for “subclinical” hypothyroidism — borderline lab results with no real symptoms — don’t actually need it.
A Dutch research team led by Dr. Jacobijn Gussekloo at Leiden University Medical Center found that the drug offered no measurable symptom improvement for some older adults with this condition.
A separate study of patients over 60 found that, after a year of gradual tapering, about a quarter could discontinue the drug entirely while keeping normal thyroid function.
Do not stop levothyroxine on your own — it requires gradual tapering with monitoring. But if you’re over 60 and on it for borderline results, ask your doctor whether you still need it. The drug can interact with other medications and isn’t free of side effects.
The bottom line
Doctors aren’t deliberately hurting their senior patients. But the medical system rewards doing things — running tests, prescribing pills, performing procedures — and the burden falls on you to ask whether each one actually makes sense at your age, given your health.
Two questions can change everything:
- What happens if we don’t do this? Make your doctor explain the actual risk of skipping the test or treatment, not the worst-case scenario.
- Is the benefit big enough to outweigh the risks at my age? A treatment that helps a 50-year-old might harm an 80-year-old. Aging changes the math.
If your doctor can’t give you a clear, confident answer, you’re entitled to push back. It’s your body, your time, and your money.
And speaking of money — even with Medicare, you’re often on the hook for copays, deductibles, and “downstream” follow-up tests. For more on what isn’t covered, see “Retirees, Beware: Medicare Will Not Cover These 11 Medical Costs.” Even the words you use when booking your annual visit can cost you hundreds in surprise bills.
Let me be clear: None of this is an argument against preventive care. Plenty of Medicare-covered screenings genuinely save lives — see “9 Free Medicare Screenings That Could Save Your Life” for the ones worth keeping on your calendar.
Saying no to the wrong test isn’t being a bad patient. It’s being a smart one.
And don’t ever make any health decision based on a single article, including this one. Always talk to your doctor before any health-related decisions.
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