Personalizing Colon Cancer Screening: Role of Age and Comorbid Conditions

Abstract

Purpose of Review

This review will discuss the impact of patient age and comorbidity on colorectal cancer (CRC) screening value.

Recent Findings

Society guidelines recommend CRC screening starting at age 50 in average-risk individuals, but there is less agreement about when screening should be discontinued. In clinical practice, CRC screening and follow-up recommendations among elderly patients appear to be driven more by chronological age than by comorbid illnesses. However, several studies have highlighted the interaction between age and comorbidity burden when selecting appropriate patients for CRC screening. Although CRC screening may be beneficial until age 75–80 years among patients with no comorbidity, it has only modest benefits at an early age in those with high comorbidity.

Summary

Clinicians should adopt the concept of "health-adjusted age" and identify "healthy elderly" patients who would benefit from CRC screening and the "unhealthy young" in whom the benefits of CRC screening are likely limited.

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