Screening colonoscopy among elderly patients over 70 years

Česká verzia

Authors: I. Mikoviny Kajzrlíková ¹; P. Vítek ^1,2; J. Chalupa ¹; J. Kuchař ¹; J. Platoš ¹; P. Řeha ¹
Authors place of work: Beskydské Gastrocentrum, Interní oddělení, Nemocnice ve Frýdku-Místku p. o. ¹; LF OU v Ostravě ²
Published in the journal: Gastroent Hepatol 2015; 69(5): 437-440
Category: Digestive Endoscopy: Original Article
doi: https://doi.org/10.14735/amgh2015437

Summary

The recommended age for a first colonoscopy screening in an average risk population is 50–55 years, but there is no upper limit. Although the prevalence of neoplastic lesions increases with age, the life expectancy decreases, which also reduces the efficiency of screening. The aim of our study was to evaluate the outcomes of screening colonoscopies in a population of over 70 years of age and compare them with those obtained in younger patients.

Methods:
The outcomes of colonoscopy examinations in a population aged 70 years and over vs. the outcomes obtained in patients under 70 years were compared using the chi-square test.

Results:
In total, 1,240 screening colonoscopies were performed, 239 in the group aged 70 years and over, and 1,001 in the group under 70 years. The polyp detection rate and adenoma detection rate were comparable in both groups. There were significantly more advanced neoplasms and carcinomas in the older group and the caecal intubation rate was lower. There were no complications in either group.

Conclusions:
Screening colonoscopy in a population of over 70 years of age in our study was safe, with a higher detection of advanced neoplasms, but with a lower completion rate.

Key words:
colonoscopy – mass screening – aged – complications – neoplasms

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
25. 8. 2015

Accepted:
28. 9. 2015

Zdroje

1. Dušek L, Májek O, Suchánek Š et al. Screening kolorektálního karcinomu v ČR po zavedení adresného zvaní – dosavadní výsledky dle dostupných dat. Gastroent Hepatol 2014; 68(5): 401–407. doi: 10.14735/amgh2014401.

2. Král N, Seifert B, Suchánek Š et a. Přístup populace ke screeningu kolorektálního karcinomu v České republice. Epidemiol Mikrobiol Imunol 2015; 64(1): 41–46.

3. Lin OS. Performing colonoscopy in elderly and very elderly patients: Risks, costs and benefits. World J Gastrointest Endosc 2014; 6(6): 220–226. doi: 10.4253/wjge.v6.i6.220.

4. Ústav zdravotnických informací a statistiky ČR. Zdravotnická ročenka České republiky 2006. Praha: ÚZIS ČR 2007.

5. Vepřeková G, Suchánek Š, Martínek J et al. Příprava střeva ke kolonoskopii. Gastroent Hepatol 2012; 66(1): 55–62.

6. Kelsen D, Daly J, Kern S et al. Environmental and lifestyle issues in colorectal cancer. In: Principles and practice of gastrointestinal oncology. Philadelphia: Lippinscott Williams and Wilkins 2008: 511–521.

7. Chan AO, Jim MH, Lam KF et al. Prevalence of colorectal neoplasm among patients with newly diagnosed coronary artery disease. JAMA 2007; 298(12): 1412–1419.

8. Suchánek Š, Májek O, Grega T et al. Cílený screening kolorektálního karcinomu u diabetiků 2. typu a osob s vysokým kardiovaskulárním rizikem – první průběžné výsledky multicentrické prospektivní studie. Gastroent Hepatol 2014; 68(5): 411–416. doi: 10.14735/amgh2014411.

9. DiPrima R, Barkin J, Blinder M et al. Age as a risk factor in colonoscopy: fact versus fiction. Am J Gastroenterol 1988; 83(2): 123–125.

10. Ma W, Mahadewa S, Kunanayagam S et al. Colonoscopy in elderly Asians: a prospective evaluation in routine clinical practice. J Dig Dis 2007; 8(2): 77–81.

11. Day LW, Kwon A, Inadomi JM et al. Adverse events in older patients undergoing colonoscopy: a systematic review and meta-analysis. Gastrointest Endosc 2011; 74(4): 885–896. doi: 10.1016/j.gie.2011.06.023.

12. Lukens FJ, Loeb DS, Machicao VI et al. Colonoscopy in octogenarians: a prospective outpatient study. Am J Gastroenterol 2002; 97(7): 1722–1725.

13. U.S. Preventive Services Task Force. Screening for colorectal cancer: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med 2008; 149(9): 627–637.

14. Carroll RL, Klein M. How often should patients be sigmoidoscoped? A mathematical perspective. Prev Med 1980; 9(6): 741–746.

15. Lin OS, Kozarek RA, Schembre DB et al. Screening colonoscopy in very elderly patients: prevalence of neoplasia and estimated impact on life expectancy. JAMA 2006; 295(20): 2357–2365.

16. Stryker SJ, Wolff BG, Culp CE et al. Natural history of untreated colonic polyps. Gastroenterology 1987; 93(5): 1009–1013.

17. Ko CW, Sonnenberg A. Comparing risks and benefits of colorectal cancer screening in elderly patients. Gastroenterology 2005; 129(4): 1163–1170.