Calculation of Stop Ages for Colorectal Cancer Screening Based on Comorbidities and Screening History

Cenin, Dayna R.; Tinmouth, Jill; Naber, Steffie K.; Dubé, Catherine; McCurdy, Bronwen R.; Paszat, Lawrence; Rabeneck, Linda; Lansdorp–Vogelaar, Iris

doi:10.1016/j.cgh.2020.05.038

Cited by 19 publications

(28 citation statements)

References 23 publications

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“…The findings by Cenin et al 3 bring us another step further down the road of personalized medicine. Clinicians can integrate their patients' gender, comorbidity status, and screening history to identify an age for stopping (Table 1).…”

Section: Q1mentioning

confidence: 93%

“…In this issue of Clinical Gastroenterology and Hepatology, Cenin et al 3 attempt to address this gap by providing ages at which women and men with varying comorbidities and prior participation in screening should stop screening. They use a CRC microsimulation model, Microsimulation Screening Analysis (MISCAN)colon.…”

Section: Q1mentioning

confidence: 99%

“…Among women with equal comorbidity, stopping ages differed by 12-20 years depending on degree of prior screening history, and even up to 24 years if prior colonoscopy was included. 3 Among women with equal prior screening, stopping ages differed by 4-12 years depending on comorbidity status. 3 This may be surprising to clinicians.…”

Section: Q1mentioning

confidence: 99%

“…3 Among women with equal prior screening, stopping ages differed by 4-12 years depending on comorbidity status. 3 This may be surprising to clinicians. Clinicians typically have a list of patient comorbidities readily available at their fingertips and a strong gestalt regarding their patients' overall health status, leading to a likely tendency to overweight comorbidities in our decision-making.…”

Section: Q1mentioning

confidence: 99%

“…This study also highlights the importance of obtaining a full screening history, including getting old records if necessary, and the need for simple and efficient ways to implement data into clinical practice in order for information regarding tailoring of CRC screening to translate into tangible population health benefits. By providing relative weighting of screening history and comorbidity, Cenin et al 3 have brought us closer to translating concepts put forth by the USPSTF and other organizations into practice.…”

Section: Q1mentioning

confidence: 99%

See 4 more Smart Citations

Screening History and Comorbidities Help Refine Stop Ages for Colorectal Cancer Screening

Calderwood

2021

Clinical Gastroenterology and Hepatology

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Section: Q1mentioning

confidence: 93%

Section: Q1mentioning

confidence: 99%

Section: Q1mentioning

confidence: 99%

Section: Q1mentioning

confidence: 99%

Section: Q1mentioning

confidence: 99%

See 3 more Smart Citations

Screening History and Comorbidities Help Refine Stop Ages for Colorectal Cancer Screening

Calderwood

2021

Clinical Gastroenterology and Hepatology

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Continuation of Screening Endoscopy for Colorectal Cancer in Older Adults

Bhoo‐Pathy

Bujang

2021

JAMA Oncol

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Colorectal cancer is not only one of the most common, but also one of the most preventable cancers globally. Screening for colorectal cancer has been associated with reduced diseasespecific mortality through detection of cancer at earlier stages, as well as through detection and removal of its precursor lesions.While most professional guidelines recommend routine screening of asymptomatic adults older than 50 years for colorectal cancer, there is disagreement on the age to stop screening. For example, the US Preventive Services Task Force (USPSTF) and the American College of Gastroenterology recommend screening until age 75 years, followed by individualized decision-making for people older than 75 years. 1,2 In contrast, the Canadian Task Force on Preventive Health does not recommend screening adults 75 years and older for colorectal cancer. 3 Likewise, the Asia Pacific Colorectal Cancer Working Group recommends 75 years as a reasonable age limit to stop screening. 4 Nonetheless, these recommendations were largely made based on evidence from modeling studies 5 and indirect evidence, such as reduced life expectancy in older individuals, and disparate inclusion of older adults in colorectal cancer screening trials. 3 Amid the scant empirical data on when best to stop offering colorectal cancer screening, in this issue of JAMA Oncology, Ma et al 6 examine the association between lower endoscopy (colonoscopy and sigmoidoscopy) and the risk of colorectal cancer, as well as its mortality in older adults (older than 75 years). By performing a robust analysis of data from 2 large prospective cohort studies, the Nurses' Health Study and the Health Professionals Follow-up Study, the authors have demonstrated that irrespective of prior endoscopic screening history, screening via colonoscopy or sigmoidoscopy after age 75 years was associated with significantly lower incidence of colorectal cancer (multivariable hazard ratio [HR], 0.61; 95% CI, 0.51-0.74) and colorectal cancer-related mortality (HR, 0.60; 95% CI, 0.46-0.78). It was also reported that no survival benefit was observed with screening endoscopy after age 75 years in participants who had cardiovascular disease (HR, 1.18; 95% CI, 0.59-2.35) or significant comorbidities (HR, 1.17; 95% CI, 0.57-2.43). Therefore, this study appears to address a widely debated topic by providing empirical evidence that points toward a reduction in risk of colorectal cancer, as well as a survival gain associated with screening colonoscopy or sigmoidoscopy in individuals older than 75 years who have no substantial comorbidities, regardless of whether they have undergone prior endoscopic screening.

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Association of Screening Lower Endoscopy With Colorectal Cancer Incidence and Mortality in Adults Older Than 75 Years

Wang

Nguyen

et al. 2021

JAMA Oncol

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IMPORTANCEEvidence indicates that screening for colorectal cancer (CRC) beginning at 50 years of age can detect early-stage CRC and premalignant neoplasms (eg, adenomas) and thus prevent CRC-related mortality. At present, the US Preventive Services Task Force recommends continuing CRC screening until 75 years of age and individualized decision-making for adults older than 75 years, while accounting for a patient's overall health and screening history. However, scant data exist to support these recommendations.OBJECTIVE To examine the association of lower gastrointestinal tract screening endoscopy with the risk of CRC incidence and CRC-related mortality in older US adults. DESIGN, SETTING, AND PARTICIPANTSThis prospective cohort study of health care professionals in the US included data from the Nurses' Health Study (NHS) and Health

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Calculation of Stop Ages for Colorectal Cancer Screening Based on Comorbidities and Screening History

Cited by 19 publications

References 23 publications

Screening History and Comorbidities Help Refine Stop Ages for Colorectal Cancer Screening

Screening History and Comorbidities Help Refine Stop Ages for Colorectal Cancer Screening

Continuation of Screening Endoscopy for Colorectal Cancer in Older Adults

Association of Screening Lower Endoscopy With Colorectal Cancer Incidence and Mortality in Adults Older Than 75 Years

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