Follow-up colonoscopies for people over age 74 who have a history of colon cancer or certain pre-cancerous polyps should be carefully considered, because the risk of hospitalization for a post-procedure adverse event may outweigh the benefits, researchers say.
An Hong Tran, MD, Kaiser geriatric fellow, found a higher risk of adverse events requiring hospitalization in seniors over age 74 — and relatively few cancers — compared with similar patients who underwent the procedure between ages 50 and 74.
"The surprising thing about our study was the differences between risks and benefits of surveillance colonoscopy (a term for a follow-up colonoscopy done several years after a prior finding of polyps or colorectal cancer) between the elderly patients and younger patients," Tran says.
Tran used data from a study of 28,000 people who underwent a colonoscopy at Kaiser Permanente Los Angeles Medical Center between 2001 and 2010. The paper was published Monday in JAMA Internal Medicine online.
Of the nearly 5,000 patients over age 74 who underwent surveillance colonoscopies, only five cancers were detected, but 527 patients required a post-procedure hospitalization within 30 days.