Guidelines say screening and surveillance can end at age 75, but many people continue to receive colonoscopies well after that time. Is there an optimal time to stop?
The recommended age for CRC screening in the United States spans 45-75 years, with the benefits of colonoscopy diminishing considerably after this point.
For instance, previously unscreened patients without comorbidities could benefit from screening beyond age 75 — up to age 80 for men and 90 for women — while those who have had regular colonoscopies, per recommended guidelines, but severe comorbidities that may limit life expectancy could stop sooner, even by age 65.
At the same time, adverse events requiring hospitalization were common 10 days post-colonoscopy , and the risk for hospitalization increased with age. At Digestive Disease Week in May, Gupta presented new research that looked at cumulative risk among patients aged 75 years and older with prior precancerous polyps vs prior normal colonoscopies. Although those with prior adenomas had a higher risk for CRC overall, their cumulative CRC risk was low — about 0.3% at 5 years and 0.8% at 10 years. Cumulative CRC deaths were even lower — 0.2% at 5 years and 0.
For example, at a prior colonoscopy, a gastroenterologist may recommend surveillance again in 5-7 years. But in the interim, the patient could have new medications or develop comorbidities and other health issues. Rather than defer to the gastroenterologist's recommendations from years ago, clinicians and patients can reassess the pros and cons of screening or surveillance based on current circumstances, Calderwood said.
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