Performing colonoscopy in elderly and very elderly patients: Risks, costs and benefits

Table 1 Yield of colonoscopy in studies with subgroups of symptomatic and/or screening/surveillance “elderly” patients

Ref.	n	Age (yr)	Completion	Cancers	Adenomas/polyps
Bat et al[10], 1992	436	80+	63%	14%	29.80%
Ure et al[48], 1995	354	70+	78%	6%	24%
Sardinha et al[49], 1999	403	80+	94%	4.50%	-
Clarke et al[12], 2001	95	85+	-	12.70%	-
Lagares-Garcia et al[50], 2001	103	80+	92.70%	11.60%	19.40%
Arora et al[51], 2004	110	80+	97%1	20%	-
Syn et al[9], 2005	225	80+	56%	11%	25%
Yoong et al[52], 2005	316	85+	69%	8.90%	14.20%
Karajeh et al[15], 2006	1000	65+	81.80%	7.10%	6%2

¹Adjusted for non-traversable stricture;

²Large polyps ≥ 1 cm in size.

Table 2 Complication risks based on data from meta-analysis by Day et al[18]

Age group (yr)	> 65	> 80
Cumulative adverse events	26.01 (25.0-27.0)	34.91 (31.9-38.0)
Perforation	1.0% (0.9-1.5)	1.5% (1.1-1.9)
Gastrointestinal bleeding	6.3% (18.0-20.3)	2.4% (1.1-4.6)
Cardiopulmonary complication	19.1% (18.0-20.3)	28.9% (26.2-31.8)
Mortality	1.0% (0.7-2.2)	0.5% (0.006-1.9)

¹Per 1000 colonoscopies.

Table 3 Outcomes for 1244 individuals who underwent screening colonoscopy; classification is according to the most advanced lesion for each patient[41]

Age group (yr)	n	Patients with advanced neoplasia	Mean life-expectancy (yr)	Mean polyp lag time2 (yr)	Mean LE extension (yr)	Adjusted mean LE extension
50-54	1034	331 (3.2%)	28.87	5.23	0.85	2.94%
75-79	147	7 (4.7%)	10.37	5.44	0.17	1.64%
80+	63	93 (14%)	7.59	3.58	0.13	1.71%

LE _extension: Extension of life expectancy due to screening colonoscopy. Adjusted LE _extension (%) = (LE _extension/LE) × 100.

¹Includes one patient with high grade dysplasia and two patients with cancers;

²These values are calculated only for patients with neoplastic findings, not the entire group;

³Includes two patients with high-grade dysplastic polyps and one with cancer.