Should Older People Still Get Colorectal Cancer Screenings?

Colorectal cancer screening past age 75 tied to lower death risk for most groups

(RxWiki News) Health officials say colorectal cancer screening can stop after age 75 in some cases. But could there be a benefit to continuing screening after that age?

A new study suggests that there could be. This research found that routine colorectal cancer screening in those older than 75 could lower the patients' risk of cancer-related death.

According to data from the Centers for Disease Control and Prevention (CDC), colorectal cancer becomes more common as people age. That includes those who are older than 75. In fact, more than 42,000 people older than 75 in the US were diagnosed with colorectal cancer in 2017.

However, the guidelines from the US Preventive Services Task Force call for routine screening starting at age 45 and ending at age 75. In those who face certain health conditions or risk factors, screening can continue after 75 under the current guidelines.

This new study set out to provide data to see whether the call to stop routine colorectal screening at age 75 was justified.

"Until now, there really weren't clear data to help us decide whether patients should be screened after age 75," said study author Dr. Andrew T. Chan, a gastroenterologist and chief of the Clinical and Translational Epidemiology Unit at Massachusetts General Hospital, in a press release. "Current guidance was largely based on modeling and extrapolation of studies conducted in other age groups, and not on solid data to show whether screening was actually helpful in an older population."

This research followed 56,374 people who reached age 75 from 1988 to 2016. Among those, the study authors identified 661 cases of colorectal cancer and 323 related deaths after 75.

But those who were screened for colorectal cancer after turning 75 were 40 percent less likely to die from cancer on average than those who did not get screened, this study found.

However, patients over 75 who had heart disease or multiple other diseases did not appear to benefit from screening.

"These are the first empirical data that really demonstrate that there is value in continuing screening past age 75 for many individuals," Dr. Chan said. "But the key take-home message is that screening should be tailored according to individual risk factors."

Colorectal screening is typically done through a colonoscopy or a sigmoidoscopy. Both procedures allow health care providers to see parts of the colon and rectum by inserting a thin, flexible tube that has a camera on it. Talk to your health care provider about when you should get screened for colorectal cancer.

This study was published in the journal JAMA Oncology.

The National Institutes of Health, Stuart and Suzanne Steele MGH Research Scholar award, MGH ECOR Tosteson and Fund for Medical Discovery Postdoctoral Fellowship funded this research. Information about potential conflicts of interest was not available at the time of publication.