Colorectal cancer screening remains essential for elderly Americans

October 15, 2007

As people get older, their risk of developing polyps and colorectal cancer increases. Currently, there is no clear evidence or established guideline for the upper age limit for colorectal cancer screening by colonoscopy. Two new studies presented at the American College of Gastroenterology’s 72nd Annual Scientific Meeting suggest continued colorectal cancer screening among healthy elderly Americans.

Dr. Matthew M. Baichi and his colleagues from the University of Buffalo and the VA Western New York analyzed the results of 587 colonoscopies performed at their institution in 2004. Fifty-six patients were age 80 or older and 531 patients were younger than 80. Researchers collected data on the number and location of adenomas, histology, presence of advanced adenomas, and colon cancer.

In this Buffalo study, colorectal adenomas were detected more frequently in older patients. Adenomas were found in 35.7 percent of patients age 80 or older and 20.4 percent of patients younger than 80. There was a trend for more proximal advanced adenomas in patients over 80 (12.5 percent) compared to those younger than 80 (6 percent). After a 2.5-year follow-up, 72 percent of patients over the age of 80 were alive compared to 82 percent of patients between the ages of 70 and 79.

“While screening colonoscopy is controversial in patients over 80, age alone should not be a contraindication to colorectal cancer screening,” says Dr. Baichi. “The results of this study suggest screening colonoscopy should be considered in healthy elderly patients.”

Screening Leads to Earlier Stage of CRC Diagnosis in Elderly Patients and Improves Survival

In separate research conducted at Scripps Clinic in La Jolla, CA, Emily G. Singh, MD, Catherine T. Frenette, MD, and Williamson B. Strum, MD, found that screening colonoscopy improves survival in elderly patients. The critical question for these researchers was whether screening colonoscopy leads to earlier stage of colorectal cancer diagnosis in the elderly, and thus improves survival in older patients.

The Scripps analysis included 243 symptomatic and 113 asymptomatic patients diagnosed with colorectal cancer between January 2000 and December 2005. Patient records were obtained from the Scripps Green Hospital Cancer Registry. Patients were divided into two groups based on symptoms and by age and stage of disease at diagnosis. The stages of colon cancer were separated at a critical point: early stage (Stage 0 – IIB) and late stage (Stage III – IV). Researchers found 101 patients had stage I colon cancer, 105 patients were diagnosed with Stage II colon cancer, 72 with Stage III, and 61 patients had stage IV colon cancer. The survival rates of all patients were evaluated from the time of initial colon cancer diagnosis.

After a two and a half year follow-up, researchers found asymptomatic patients had significantly improved survival compared to symptomatic patients. There was a sustained difference in stage of disease favoring patients who were asymptomatic, for all ages between 50 and 84, suggesting a role for preventive screening even among those of advancing age. According to Dr. Emily Singh, “We conclude that there is a role for screening colonoscopy in asymptomatic individuals without significant comorbidities up to age 84.” Neither the American College of Gastroenterology nor any other guideline groups currently set an upper age limit for colorectal cancer screening by colonoscopy.

Source: American College of Gastroenterology

Explore further: Genes activated in metastasis also drive the first stages of tumour growth

Related Stories

Genes activated in metastasis also drive the first stages of tumour growth

February 21, 2018
In spite of the difference between the cell functions responsible for giving rise to a tumour and that give rise to metastasis, studies at IRB Barcelona using the fly Drosophila melanogaster reveal that some genes can drive ...

Race, insurance status linked to job loss after breast cancer

February 15, 2018
Job loss following early-stage breast cancer diagnosis is associated with race and insurance status, but not with any clinical or treatment-related factors, finds a new study from the Brown School at Washington University ...

The same test, regardless of cancer type

February 16, 2018
Researchers at the Institute for Cancer Genetics and Informatics at Oslo University Hospital (OUS), have developed a method that can assess the seriousness of a patient's cancer and what treatment is required.

Genetic test identifies 'high risk' lymphatic cancer patients

February 20, 2018
Around 1,500 people in Denmark are diagnosed with lymphatic cancer each year. A small sub-group (70 to 80 people) develop a rare and aggressive type of lymphatic cancer, known as mantle cell lymphoma (MCL).

Catching up to brain cancer: Researchers develop accurate model of how aggressive cancer cells move and spread

February 15, 2018
A brief chat at a Faculty Senate meeting put two University of Delaware researchers onto an idea that could be of great value to cancer researchers.

Patients often mispredict well-being after mastectomy

February 16, 2018
(HealthDay)—Adult women undergoing mastectomy underestimate future well-being after mastectomy alone and overestimate well-being after reconstruction, according to a study published online Feb. 7 in JAMA Surgery.

Recommended for you

Study tracks evolutionary transition to destructive cancer

February 23, 2018
Evolution describes how all living forms cope with challenges in their environment, as they struggle to persevere against formidable odds. Mutation and selective pressure—cornerstones of Darwin's theory—are the means ...

Researchers use a molecular Trojan horse to deliver chemotherapeutic drug to cancer cells

February 23, 2018
A research team at the University of California, Riverside has discovered a way for chemotherapy drug paclitaxel to target migrating, or circulating, cancer cells, which are responsible for the development of tumor metastases.

Lab-grown 'mini tumours' could personalise cancer treatment

February 23, 2018
Testing cancer drugs on miniature replicas of a patient's tumour could help doctors tailor treatment, according to new research.

An under-the-radar immune cell shows potential in fight against cancer

February 23, 2018
One of the rarest of immune cells, unknown to scientists a decade ago, might prove to be a potent weapon in stopping cancer from spreading in the body, according to new research from the University of British Columbia.

Putting black skin cancer to sleep—for good

February 22, 2018
An international research team has succeeded in stopping the growth of malignant melanoma by reactivating a protective mechanism that prevents tumor cells from dividing. The team used chemical agents to block the enzymes ...

Cancer risk associated with key epigenetic changes occurring through normal aging process

February 22, 2018
Some scientists have hypothesized that tumor-promoting changes in cells during cancer development—particularly an epigenetic change involving DNA methylation—arise from rogue cells escaping a natural cell deterioration ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.