Would You Recommend Screening Colonoscopy for the Very Elderly?

Abstract

Life expectancy in Korea has increased, and the number of screening colonoscopies in the elderly has also dramatically increased. The net benefit of colonoscopy in the very elderly (≥80 years of age as defined by the World Health Organization) may be reduced because of the competing risk of mortality due to other diseases. Therefore, the decision to perform screening colonoscopy may be more complex in this age group. As the potential increase in life expectancy due to screening colonoscopy is significantly reduced in the very elderly, this procedure should be limited to those among the very elderly who have substantial life expectancies. Furthermore, considering the common major complications associated with colonoscopy, poor bowel preparation, and the possibility of incomplete colonoscopies in the very elderly, the performance of screening colonoscopy in the very elderly may not be an ideal recommendation. In terms of providing the greatest benefit to the most number of people, patients with the highest potential gain in terms of life expectancy, relative to the diagnostic yield, should be targeted for colonoscopy screening. This review addresses the unique considerations regarding screening colonoscopy in the very elderly and the individualized approach, which involves the weighing of the risks and benefits for each individual with consideration of their overall health status.

Adenoma Detection Rate Evaluation and Quality of Colonoscopy in the Center-West Region of Brazil

“…This may occur due to slowed bowel motility, previous surgeries and other comorbidities, a high rate of constipation, poor adherence, and misunderstanding of the preparation instructions. Some authors recommend that older patients undergo pre-procedure consultations for evaluation, and that an individualized approach is used to improve preparation rates (6) . Another parameter recommended by ASGE as a quality criterion is a cecal intubation rate greater than 95; in the study population, the rate found was 100%.…”

Low-Volume Polyethylene Glycol with Ascorbic Acid for Colonoscopy Preparation in Elderly Patients: A Randomized Multicenter Study

“…Life expectancy has increased worldwide; accordingly, the number of screening colonoscopies performed in elderly patients has dramatically increased [1,2] . As the incidence of colorectal cancer increases with age, colonoscopy plays a major role in the detection of CRCs in elderly patients [1,2] .…”

“…As the incidence of colorectal cancer increases with age, colonoscopy plays a major role in the detection of CRCs in elderly patients [1,2] . Although the yield of colonoscopy in elderly patients is high, colonoscopy in this population is often difficult because of higher rates of adverse events and noncompliance than in younger patients.…”

Associations Between Parameters of Glucose and Lipid Metabolism and Risk of Colorectal Neoplasm

“…Moreover, the incidence of CRC is rapidly increasing, especially in Asian countries including Korea [2][3][4][5]. The substantial interest in identifying potentially modifiable risk factors, such as cigarette smoking, diabetes, hyperlipidemia, and obesity, have kept pace with the increase in incidence of CRC.…”