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May 20, 2021

Continuation of Screening Endoscopy for Colorectal Cancer in Older Adults

Author Affiliations
  • 1Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
  • 2Ministry of Health Malaysia, Menara Prisma, Persiaran Perdana, Putrajaya, 10 Wilayah Persekutuan Putrajaya, Malaysia
JAMA Oncol. 2021;7(7):973-975. doi:10.1001/jamaoncol.2021.1119

Colorectal cancer is not only one of the most common, but also one of the most preventable cancers globally. Screening for colorectal cancer has been associated with reduced disease-specific mortality through detection of cancer at earlier stages, as well as through detection and removal of its precursor lesions.

While most professional guidelines recommend routine screening of asymptomatic adults older than 50 years for colorectal cancer, there is disagreement on the age to stop screening. For example, the US Preventive Services Task Force(USPSTF) and the American College of Gastroenterology recommend screening until age 75 years, followed by individualized decision-making for people older than 75 years.1,2 In contrast, the Canadian Task Force on Preventive Health does not recommend screening adults 75 years and older for colorectal cancer.3 Likewise, the Asia Pacific Colorectal Cancer Working Group recommends 75 years as a reasonable age limit to stop screening.4 Nonetheless, these recommendations were largely made based on evidence from modeling studies5 and indirect evidence, such as reduced life expectancy in older individuals, and disparate inclusion of older adults in colorectal cancer screening trials.3

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