When to Stop Surveillance Colonoscopy in Older Adults

Most older adults who have had an adenoma detected on colonoscopy continue to undergo surveillance. But the benefit remains unclear, particularly given competing mortality risks as people age, and current guidelines offer no recommended age or frailty-related cutoffs.

To address this uncertainty, researchers conducted a retrospective study in 90,000 U.S. veterans (98% male) who had a screening colonoscopy at or after age 65 years. They compared the risks of colorectal cancer (CRC) incidence, CRC death, and non-CRC death between those who had an adenoma detected on their last colonoscopy before age 75 (28% of the cohort) and those who did not.