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Purpose of Review <p>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&#xa0;million adults over 65 years projected by 2035, optimizing CRC screening and surveillance is crucial. This review examines guidelines, risks, and personalized approaches.</p> Recent Findings <p>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.</p> Summary <p>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.</p>

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

  • 期刊论文

  • 发表日期：

    2025年6月2日

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

摘要

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.

Summary

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.