From the Research
For patients aged 75 and older with a history of colorectal cancer, surveillance colonoscopy should be considered on an individualized basis, taking into account the patient's life expectancy, comorbidities, functional status, and preferences, as recommended by the most recent study 1. The decision to continue surveillance should be based on a case-by-case discussion with the patient, considering multiple factors including the patient's morbidity and mortality risk from colorectal cancer, underlying comorbidities, functional status, and preferences for screening 2. Key factors to consider when deciding on surveillance colonoscopy in older adults include:
- Life expectancy: patients with a life expectancy of at least 10 years may benefit from continued surveillance 2
- Comorbidities: patients with significant comorbidities may not benefit from surveillance due to competing causes of mortality 1
- Functional status: patients with poor functional status may not be able to undergo treatment if new lesions are found, and surveillance may not be beneficial 3
- Preferences: patient preferences should be taken into account when deciding on surveillance colonoscopy, as some patients may prioritize the potential benefits of surveillance over the risks and discomfort of the procedure 4 The recommended interval for surveillance colonoscopy is typically every 3-5 years, depending on findings from the previous colonoscopy and the patient's overall health status, but this should be individualized based on the patient's specific situation 1. It is essential to weigh the benefits of surveillance against the risks of the procedure and the patient's overall health status, as the risks of complications from bowel preparation, the procedure, and sedation medications are increased in older patients 2.