The likely value of screening colonoscopy (SC) depends not just on the age and sex of the patient, but also on the number of co-morbidities a person has, according to a new study.
Initial guidelines for cancer screening, including SC to detect early-stage colorectal cancer (CRC), did not recommend an upper age limit for screening.
In 2008 the United States Preventive Services Task Force recommended against routine SC in patients 76-85 years old, and against any screening for CRC in patients older than 85.
The task force based its recommendations on diminishing benefit of SC with increasing age.
Researches in a new study found that taking into account the number of co-morbidities affected whether a patient was likely to benefit from SC, even after accounting for age.
For both men and women aged 85-94 with no co-morbidities, SC is estimated to save around 100 life-years per 100,000 patients screened (65 life-years for men, 111 life-years for women).
However, for men and women with at least three co-morbidities, there were no life-years saved for patients older than 74.
For more info, see Gross et al. (2011). Assessing the impact of screening colonoscopy on mortality in the Medicare population. Journal of General Internal Medicine, 26(12), 1441-1449.