Study supports continued colorectal cancer screening of elderly patients

Patients age 75 years and older are as likely as younger patients to benefit from colorectal cancer (CRC) screening, investigators report this week at the 70th Annual Scientific Meeting of the American College of Gastroenterology in Honolulu.

While guidelines advocate CRC screening beginning at age 50 for individuals at average risk, there is no consensus regarding the age at which clinicians should stop screening.”The problem is that as patients get older, and now that we have an elderly population that is growing, physicians are sometimes hesitant to screen patients because of the risks from sedation,” lead investigator Dr. Aaron Walfish told Reuters Health. “But the point is, as patients get older, they may actually have a higher risk of getting polyps and colorectal cancer.”To assess the risks, Dr. Walfish, from Beth Israel Medical Center in New York, and his colleagues conducted a retrospective analysis of 178 patients 75 and older and 318 patients between ages 65 and 69. According to their meeting materials, the researchers found that a similar percentage of patients had polyps or masses in both age groups — 43% in the 75 and older group versus 42% in the 65 to 69 group. There were also similar proportions that had polyps or masses 1 cm in diameter or larger.There were no complications from the screening procedure reported in either age group. Dr. Walfish acknowledged that older patients are at higher risk of complications from surgery. “But if we take out polyps early during colonoscopy, hopefully they won’t have to go to surgery,” he noted.The bottom line, he added, is “physicians should continue CRC screening as patients get older.”(Source: Reuters Health: Oncolink: Karla Gale: November 2005.)