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Colorectal Cancer Screening and Surveillance Colonoscopy in Older Adults

  • Colon (JC Anderson, Section Editor)
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Abstract

Purpose of review

The purpose of this chapter is to highlight current recommendations regarding colorectal cancer (CRC) screening and post-polypectomy surveillance colonoscopy in older adults and to review the available literature in order to help inform decision-making in this age group.

Recent findings

Age is a risk factor for CRC; however, older adults with a history of prior screening are at lower risk for CRC compared to those who have never been screened. Decision-making for CRC screening and post-polypectomy surveillance colonoscopy in older adults is complex and several factors including age, screening history, comorbidities, functional status, bowel preparation, prior experiences, preferences, and barriers need to be considered when weighing risks and benefits. Recent guidelines have started to incorporate life expectancy and prior screening history into their recommendations; however, how to incorporate these factors into actual clinical practice is less clear.

Summary

There are limited data on the relative benefits of screening and surveillance in older adults and therefore, at this time, decision-making should be individualized and incorporate patient preferences in addition to medical factors.

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Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Michigan Medicine, Ann Arbor, MI, USA

    Jennifer K. Maratt MD, MS

  2. Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI, USA

    Jennifer K. Maratt MD, MS

  3. Section of Gastroenterology, Department of Medicine, Dartmouth Geisel School of Medicine and the Dartmouth Institute for Health Policy and Clinical Practice, One Medical Center Drive, Lebanon, NH, 03756, USA

    Audrey H. Calderwood MD, MS

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  1. Jennifer K. Maratt MD, MS
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Correspondence to Audrey H. Calderwood MD, MS.

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Jennifer K. Maratt declares that she has no conflict of interest. Audrey H. Calderwood declares that she has no conflict of interest.

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Maratt, J.K., Calderwood, A.H. Colorectal Cancer Screening and Surveillance Colonoscopy in Older Adults. Curr Treat Options Gastro 17, 292–302 (2019). https://doi.org/10.1007/s11938-019-00230-9

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