At what age should a one-time only colonoscopy for screening of colorectal cancer be performed?
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.
Delcò
F
F
The Department of Veterans Affairs Medical Center, and University of New Mexico, Albuquerque 87108, USA.
Sonnenberg
A
A
D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy / Q000191:economics / Q000706:statistics & numerical data*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000401:mortality*; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008017:Life Expectancy; D015993:Life Tables; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged