Abstract
Guidelines for colorectal cancer screening by the American College of Physicians do not recommend screening for patients aged 75 years or with a life expectancy of ＜10 years. In the rapidly aging Japanese population, and also the number of colonoscopy (CS) for elderly has been increasing. [Subjects and Methods] A retrospective study was conducted in 2013 for 78 patients aged 90 years who underwent CS at our hospital between 2005 and 2008. Questionnaire respondents were divided into asymptomatic, symptomatic (such as bloody stool) , or treatment groups (surgical or endoscopic treatment) . Median survival time (MST) for each group was calculated using Kaplan−Meier analysis to determine the effectiveness of CS in elderly patients. Patients in the control group with the same age and gender distribution as the respondents underwent upper endoscopy at our hospital during the same 4−year period. [Results] All 56 respondents or their family members were satisfied with CS. The initial mean patient age was 91.7±1.6 (90−98) years. The final mean patient age was 95.1±2.3 years. MST after screening was 3.7 years and not significantly different from that in the control group. Among the five groups (asymptomatic [n＝26], symptomatic [n＝30], treatment [n＝25], all cases [n＝56], and control [n＝56]) , no significant differences in MST or survival rate were observed. [Conclusions] Life expectancy for patients 90 years was not extended significantly by CS. These symptomatic patients receiving screening and treatment were unlikely to have reduced life expectancy. And these patients and their family members were highly satisfied with CS. The upper age limit for CS screening in asymptomatic elderly patients must be re-evaluated in Japan.
