Colonoscopy Screening May Not Be Beneficial for Elderly Adults

Colonoscopy screening may not reduce the risk of colorectal cancer for adults aged 70 to 79 years, according to new research.

Current guidelines recommend routine screening of adults aged 50 to 75 years and screening on a case-by-case basis for adults aged 76 to 85 years. However, trials of screening colonoscopy have not included adults over the age of 75.
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To determine the effectiveness and safety of screening in preventing colorectal cancer, the researchers examined data from 1,355,692 adults aged 70 to 79 years who were at average risk for colorectal cancer and who used Medicare preventive services.

Participants were included if they did not have a colonoscopy within 5 years before baseline, which was from 2004 to 2012. The researchers then separated the participants into 2 groups: colonoscopy screening and no screening.

After an 8-year follow-up, the colorectal cancer risk for participants aged 70 to 74 years was 2.19% in the screening group and 2.62% in the no-screening group, and for participants aged 75 to 79 years was 2.84% in the screening group and 2.97% in the no-screening group.

Screening was also associated with a 30-day risk for adverse events in participants aged 70 to 74 years (5.6 adverse events per 1000 adults) and in those aged 75 to 79 years (10.3 excess events per 1000 adults).

“Screening colonoscopy may have had a modest benefit in preventing [colorectal cancer] in beneficiaries aged 70 to 74 years and a smaller benefit in older beneficiaries,” the researchers concluded. “The risk for adverse events was low but greater among older persons.”

—Amanda Balbi

Reference:

García-Albéniz X, Hsu J, Bretthauer M, Hernán MA. Effectiveness of screening colonoscopy to prevent colorectal cancer among Medicare beneficiaries aged 70 to 79 years: a prospective observational study [published online September 27, 2016]. Ann Intern Med. doi:10.7326/M16-0758.