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At what age should a one-time only colonoscopy for screening of colorectal cancer be performed?
1The Department of Veterans Affairs Medical Center, and University of New Mexico, Albuquerque 87108, USA.
Objective:
To determine at what age the only screening colonoscopy during lifetime should be performed to achieve the highest yield.
Methods:
Medical decision analysis to calculate the loss in life years associated with mortality from colorectal cancer at different ages.
Results:
The expected loss in life years from colorectal cancer is highest between the ages 70 to 80 years, with a peak occurring at age 75. The length of protection provided by colonoscopy plus polypectomy is estimated to last 5-10 years after the procedure. A screening colonoscopy at age 65 would, thus, protect a subject from age 65 until age 70 or 75 years. Similarly, a screening colonoscopy at age 70 would protect the subject from age 70 until age 75 or 80 years.
Conclusions:
The highest yield in life years by preventing death from colorectal cancer is achieved if the only colonoscopy per lifetime is scheduled between the ages of 65 and 70 years.