Problems in screening colorectal cancer in the elderly.
OBJECTIVE
To explore the problems in the screening of colorectal carcinoma in the elderly.


METHODS
Three models of colorectal cancer prevention were examined: standard screening, active check-up of suspected cases and summons to have endoscopic check-up for previously diagnosed colorectal polyps. The study was performed among three groups of elderly individuals: Group 1 (167 cases), hospitalized asymptomatic individuals without symptoms in large intestines. Group 2 (612 cases): old individuals at home for the aged, out of which 32 showed symptoms of colon disorders; Group 3 (44 cases): elderly people with diagnosed polyps. As a result of 1788 rectosigmoidoscopies, we identified 61 individuals with polyps, out of which 44 patients were over 65 years old. However, only 9 of these 44 individuals agreed to have the endoscopy performed again.


RESULTS
One cancer and 13 polyps were detected in Group 1, and two polyps in Group 2. However, it should be noted that only eleven individuals from Group 2 agreed to have the endoscopy. In Group 3, there were no relapses of the polyps among the nine individuals who came back for the endoscopy.


CONCLUSIONS
Poor understanding of the screening procedures is one of the greatest problems in early detection of the cancer in the aged. Paradoxically, the cooperation is better with hospitalized patients, than with "successfully old" persons.
Mladen
Davidović M
DM
Center of Geriatric Medicine, 11050 Beograd, Rifata Burdzevica 31, Yugoslavia. davidovi@EUnet.yu
Dragoslav
Milosevic P
MP
Sanja
Zdravkovic
Z
Bozidar
Bojic
B
Snezana
Djurica
D
D000368:Aged; D000369:Aged, 80 and over; D003111:Colonic Polyps / Q000175:diagnosis* / Q000517:prevention & control*; D003113:Colonoscopy / Q000523:psychology; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000517:prevention & control*; D006801:Humans; D008403:Mass Screening / Q000523:psychology*; D009042:Motivation; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance