Current Perspectives on Colorectal Cancer Screening and Surveillance in the Geriatric Population.

Q1 Medicine

Current Gastroenterology Reports Pub Date : 2025-06-02 DOI:10.1007/s11894-025-00985-5

Jahnavi Udaikumar, Rithish Nimmagadda, Sushrut Ingawale, Vindhya Vasini Lella, Keerthika Vijayakumar, Adam S Faye, Aasma Shaukat

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Abstract

Purpose of review: Colorectal cancer (CRC) is a leading cause of cancer-related mortality, with 44% of deaths occurring in individuals aged 75 years and older. With 78 million adults over 65 years projected by 2035, optimizing CRC screening and surveillance is crucial. This review examines guidelines, risks, and personalized approaches.

Recent findings: CRC screening reduces incidence by 17-33% and mortality by 11-53%. Colonoscopy lowers mortality by 61% but has a 6.8% complication rate in those aged 75 years and older. The risk of gastrointestinal bleeding is 8.7 per 1,000 for polypectomy, and perforation occurs in 0.6 per 1,000. Frailty indices assess suitability, but surveillance guidelines lack clear discontinuation criteria. Screening should balance risk, complications, and health status. It may be cost-effective up to age 86 years in healthy individuals, but more research is needed to refine surveillance strategies and reduce overtreatment in older adults.

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老年人群结直肠癌筛查和监测的现状。

综述目的：结直肠癌（CRC）是癌症相关死亡的主要原因，44%的死亡发生在75岁及以上的人群中。到2035年，预计65岁以上的成年人将达到7800万，优化CRC筛查和监测至关重要。这篇综述考察了指导方针、风险和个性化的方法。最近发现：CRC筛查可使发病率降低17-33%，死亡率降低11-53%。结肠镜检查可降低61%的死亡率，但75岁及以上患者的并发症发生率为6.8%。息肉切除术发生胃肠道出血的风险为千分之8.7，穿孔发生率为千分之0.6。虚弱指数评估适宜性，但监测指南缺乏明确的停药标准。筛查应平衡风险、并发症和健康状况。对于86岁以下的健康人来说，它可能具有成本效益，但需要更多的研究来完善监测策略并减少老年人的过度治疗。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Gastroenterology Reports Medicine-Gastroenterology

CiteScore

7.80

自引率

0.00%

发文量

期刊介绍： As the field of gastroenterology and hepatology rapidly evolves, the wealth of published literature can be overwhelming. The aim of the journal is to help readers stay abreast of such advances by offering authoritative, systematic reviews by leading experts. We accomplish this aim by appointing Section Editors who invite international experts to contribute review articles that highlight recent developments and important papers published in the past year. Major topics in gastroenterology are covered, including pediatric gastroenterology, neuromuscular disorders, infections, nutrition, and inflammatory bowel disease. These reviews provide clear, insightful summaries of expert perspectives relevant to clinical practice. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.