Colorectal cancer screening remains essential for elderly Americans

As people get older, their risk of developing polyps and colorectal cancer increases. Currently, there is no clear evidence or established guideline for the upper age limit for colorectal cancer screening by colonoscopy. Two new studies presented at the American College of Gastroenterology’s 72nd Annual Scientific Meeting suggest continued colorectal cancer screening among healthy elderly Americans.

Dr. Matthew M. Baichi and his colleagues from the University of Buffalo and the VA Western New York analyzed the results of 587 colonoscopies performed at their institution in 2004. Fifty-six patients were age 80 or older and 531 patients were younger than 80. Researchers collected data on the number and location of adenomas, histology, presence of advanced adenomas, and colon cancer.

In this Buffalo study, colorectal adenomas were detected more frequently in older patients. Adenomas were found in 35.7 percent of patients age 80 or older and 20.4 percent of patients younger than 80. There was a trend for more proximal advanced adenomas in patients over 80 (12.5 percent) compared to those younger than 80 (6 percent). After a 2.5-year follow-up, 72 percent of patients over the age of 80 were alive compared to 82 percent of patients between the ages of 70 and 79.

“While screening colonoscopy is controversial in patients over 80, age alone should not be a contraindication to colorectal cancer screening,” says Dr. Baichi. “The results of this study suggest screening colonoscopy should be considered in healthy elderly patients.”

Screening Leads to Earlier Stage of CRC Diagnosis in Elderly Patients and Improves Survival

In separate research conducted at Scripps Clinic in La Jolla, CA, Emily G. Singh, MD, Catherine T. Frenette, MD, and Williamson B. Strum, MD, found that screening colonoscopy improves survival in elderly patients. The critical question for these researchers was whether screening colonoscopy leads to earlier stage of colorectal cancer diagnosis in the elderly, and thus improves survival in older patients.

The Scripps analysis included 243 symptomatic and 113 asymptomatic patients diagnosed with colorectal cancer between January 2000 and December 2005. Patient records were obtained from the Scripps Green Hospital Cancer Registry. Patients were divided into two groups based on symptoms and by age and stage of disease at diagnosis. The stages of colon cancer were separated at a critical point: early stage (Stage 0 – IIB) and late stage (Stage III – IV). Researchers found 101 patients had stage I colon cancer, 105 patients were diagnosed with Stage II colon cancer, 72 with Stage III, and 61 patients had stage IV colon cancer. The survival rates of all patients were evaluated from the time of initial colon cancer diagnosis.

After a two and a half year follow-up, researchers found asymptomatic patients had significantly improved survival compared to symptomatic patients. There was a sustained difference in stage of disease favoring patients who were asymptomatic, for all ages between 50 and 84, suggesting a role for preventive screening even among those of advancing age. According to Dr. Emily Singh, “We conclude that there is a role for screening colonoscopy in asymptomatic individuals without significant comorbidities up to age 84.” Neither the American College of Gastroenterology nor any other guideline groups currently set an upper age limit for colorectal cancer screening by colonoscopy.

Source: American College of Gastroenterology

Related stories:

OU researchers developing new tool to detect cancer
Early cancer detection can significantly improve survival rates. Current diagnostic tests often fail to detect cancer in the earliest stages and at the same time expose a patient to the harmful effects of radiation. Led by Dr. Patrick McCann, a small group of internationally known researchers at the University of Oklahoma with expertise in the development of mid-infrared lasers is working to create a sensor to detect biomarker gases exhaled in the breath of a person with cancer.
Gene that causes childhood cancer neuroblastoma is found
Scientists have discovered gene mutations that are the main cause of the inherited version of the childhood cancer neuroblastoma. In addition, the researchers found that the same mutations play a significant role in high-risk forms of non-inherited neuroblastoma, the more common form of the disease.
Japanese create stem cells from wisdom teeth
Japanese scientists said Friday they had derived stem cells from wisdom teeth, opening another way to study deadly diseases without the ethical controversy of using embryos.
Researchers discover how rheumatoid arthritis causes bone loss
Researchers have discovered key details of how rheumatoid arthritis (RA) destroys bone, according to a study published in the Aug. 22 edition of the Journal of Biological Chemistry. The findings are already guiding attempts to design new drugs to reverse RA-related bone loss and may also address more common forms of osteoporosis with a few adjustments.
Stem cell indicator for bowel cancer should lead to better survival rates
Stem cell scientists have developed a more accurate way of identifying aggressive forms of bowel cancer, which should eventually lead to better treatment and survival rates. Bowel cancer is the third most common cancer in the UK.
Experiments could lead to new treatments for neuroblastoma
Neuroblastoma is one of the most devastating diagnoses a child can receive. The cancer's victims average 2 years old when the disease is detected, most often by a parent feeling a lump in a child's abdomen. By then, the disease has often reached an advanced stage, and advanced neuroblastoma kills more than 50 percent of the children in whom it develops, despite aggressive treatment with surgery, chemotherapy and radiation.
Prototype test for predicting clinical outcome for melanoma patients
Investigators from the Melbourne Center of the international Ludwig Institute for Cancer Research (LICR) and Pacific Edge Biotchnology Ltd today reported that they have developed a test to predict whether a patient will progress rapidly from Stage III melanoma to metastatic Stage IV cancer and death.
Protein key to control, growth of blood cells
New research sheds light on the biological events by which stem cells in the bone marrow develop into the broad variety of cells that circulate in the blood. The findings may help improve the success of bone marrow transplants and may lead to better treatments for life-threatening blood diseases.

News discussion:

Medicine & Health news