I hear many people saying that above age 75 one does not need a colonoscopy. This comes from a misunderstanding of colon cancer screening guidelines which say that certain individuals could consider stopping colon cancer screening at age 75. The following table summarizes the 2017 recommendations by the U.S. Multi-Society Task Force of Colorectal Cancer (MSTF) regarding age limits. The MSTF represents the American College of Gastroenterology, the American Gastroenterological Association, and The American Society for Gastrointestinal Endoscopy.
What is screening anyway?
First, let us be clear about the word screening. Screening means that you – and your doctor – are considering colonoscopy solely for early detection of colon cancer, and you don’t have any symptoms such as anemia, abdominal pain or rectal bleeding. If you do have these symptoms, colonoscopy may be the right test at almost any age.
Now back to the MSTF screening guidelines:
|Age 75 and above – Not too old for colonoscopy||Age 75 and above – Probably too old for colonoscopy (unless you have symptoms)|
|If you have never had colon cancer screening||If you have serious other diseases|
|If you are at high risk for colon cancer because of personal history or family history (this is actually not screening but surveillance)||If your life expectancy is less than 10 years|
|If you are older than 85||Previously negative screening, especially with colonoscopy (must be up-to-date)|
It is sometimes difficult to apply the guidelines to the situation of individual patients. This does not only apply to older individuals but also to those who have certain risk factors and should be screened at a younger age than 50. See the concerns about rising colon cancer rates in younger individuals. Ultimately, you need to discuss this with your primary care physician or gastroenterologist. Follow this link to make an appointment.
Rex, Douglas K., et al. “Colorectal cancer screening: Recommendations for physicians and patients from the US Multi-Society Task Force on Colorectal Cancer.” Gastroenterology 153.1 (2017): 307-323.