Is Colorectal Cancer Screening Indicated in Previously Unscreened Elders?

The U.S. Preventive Services Task Force advises against colorectal cancer (CRC) screening in patients older than 85; for unscreened people who are 75 to 85, decisions to screen should be guided by the “individual's health status and competing risks” (NEJM JW Gen Med Oct 28 2008). However, few data are available to guide clinicians on screening previously unscreened older patients. Using modeling, researchers evaluated to what age CRC screening should be considered in unscreened, average-risk elders (age range, 76–90). Strategies included one-time colonoscopy, sigmoidoscopy, or fecal immunochemical testing (FIT).

Compared with no screening, CRC screening at age 80 prevented 4.2 (1-time FIT) to 10.7 (1-time colonoscopy) CRC-related deaths for …