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When to stop colorectal screening

Q. I’m 76 and I have had three normal colonoscopies for routine colorectal cancer screening. Am I done now?

A. Recommendations for screening tests like colonoscopy usually state an age to start being screened, but when to stop is more of a gray area. Whether to continue screening depends on your overall health and how likely it is that you are still at risk for the disease. Remember, screening tests are performed to look for a problem years before it would likely appear. Colonoscopy, for example, detects the precancerous polyps that appear many years before the polyps turn into cancer.

The risk of colon cancer increases over time, but if no polyps were found on previous colonoscopies, the chance of new colon polyps is markedly lower. On the other hand, a family history of colon cancer increases your risk.

The United States Preventive Services Task Force, which provides guidance on many screening tests, advises that everyone be screened until age 75, and that screening should stop after age 85 since the likelihood of benefit at that age is small. For people ages 76 to 85 at average risk, colonoscopy may be skipped if you have other serious medical problems that should receive priority.

In addition, if your test results are normal until age 75, you are at low risk of future polyps and can also skip further testing. Of course, symptoms of colon cancer, such as rectal bleeding or a significant change in bowel habits, should never be ignored, even if previous colonoscopies have been normal.

— William Kormos, M.D.
Editor in Chief, Harvard Men’s Health Watch

Posted by: Dr.Health

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