Original ArticleClinical EndoscopySurvival of elderly persons undergoing colonoscopy: implications for colorectal cancer screening and surveillance
Section snippets
Material and methods
We conducted a retrospective cohort study at the Roudebush Veterans Affairs Medical Center (VAMC) and the Wishard Memorial Hospital in Indianapolis, Indiana. The Roudebush VAMC is a regional referral facility in the Veterans Affairs system, and Wishard Memorial Hospital is a large urban county hospital that serves the indigent population of Indianapolis. The endoscopy suites in both hospitals are open-access units. The study protocol was approved by the institutional review boards of Indiana
Results
Between January 1, 1999, and December 31, 2000, 469 subjects aged 75 years and older underwent colonoscopy at the 2 study sites; 65 were excluded (36 with incomplete colonoscopy, 25 with history of CRC, and 4 with inflammatory bowel disease), leaving 404 for inclusion in the study. Of 404 patients, 261 (65%) were from the VAMC. The mean (±SD) age of the entire cohort was 79 ± 3 years (range, 75 to 92 years); 74% (n = 297) were male and 70% were white (n = 283). There was no difference in mean
Discussion
Colonoscopy has become a popular modality for CRC screening and is recommended starting at age 50 years for average-risk patients; however, current guidelines do not specify an upper age limit. Elderly patients are underrepresented in the literature supporting CRC screening, and it is not known whether the benefits of screening apply to older age groups. Furthermore, the elderly are a heterogeneous group, and it is unrealistic to expect that there is a single age threshold beyond which
Acknowledgments
We thank Michele Starkey (Indiana State Department of Health), Beverly Musick and Tiera Hastings (database management), Ada Yeung, Faye Smith, Roberta Ambuehl, and Jennifer Schaffter Stuart (data collection).
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