Association of life expectancy with surveillance colonoscopy findings and follow-up recommendations in older adults
Key points
Question
Is estimated life expectancy associated with surveillance colonoscopy findings and recommendations for follow-up colonoscopy in older adults?
Findings
In this cohort study of 9831 adults 65 years and older in New Hampshire, 8% had advanced polyps or colorectal cancer during surveillance colonoscopy.Most patients were advised to return for a future colonoscopy, even if life expectancy was limited.
Meaning
These findings suggest that the recommendation against future surveillance colonoscopy in older adults with low-risk colonoscopy findings and/or limited life expectancy should be considered more frequently than is currently practiced.
Importance
Surveillance after previous colon polyps is the most common indication for colonoscopy in older adults. However, to our knowledge, the current use of surveillance colonoscopy, clinical outcomes and follow-up recommendations in relation to life expectancy, taking into account age and comorbidities, have not been studied.
Objective
To assess the association of estimated life expectancy with surveillance colonoscopy findings and follow-up recommendations among older adults.
Design, environment and participants
This registry-based cohort study used data from the New Hampshire Colonoscopy Registry (NHCR) linked to Medicare claims data and included adults in the NHCR who were over 65 years of age, underwent colonoscopy for surveillance after previous polyps between April and December 1, 2009 and December 31, 2018, and had full Medicare Part A and B coverage and was not enrolled in a Medicare managed care plan in the year prior to colonoscopy.Data were analyzed from December 2019 to March 2021.
Source – https://www.intramed.net/103853