title: Flexible sigmoidoscopy for colorectal cancer screening in the elderly.
abstract: Data on performance characteristics of flexible sigmoidoscopy (FS) between age groups are limited. This study evaluates screening FS in subjects > or = 75 years of age (elderly) compared with ages 50-74 years (general screening population). Data were collected on patient characteristics, insertion depth, procedural difficulties, complications, and endoscopic findings. There was an increased rate of endoscopist-reported limitations (50.4% vs. 34.9%; P = 0.0001) and incomplete examinations (15.6% vs. 5.4%; P = 0.0001) in the elderly cohort relative to subjects aged 50-74. The complication rate (1.0% vs. 1.5%; P = 0.53), adenoma detection rate (7.2% vs. 5.6%; P = 0.213), and advanced adenoma detection rate (0.71% vs 0.65%; P = 0.86) were similar. More carcinomas were detected in the elderly (0.53% vs. 0.06%; P = 0.042). Factors associated with incomplete examinations in the elderly included age, female gender, and poor bowel preparation. Despite technical difficulties, FS in the elderly is safe and detects significant pathology.
authors.affiliation: Section of Gastroenterology, Boston University School of Medicine, 85 East Concord Street, Boston, Massachusetts 02118, USA.
authors.forename: Ajay
authors.initials: A
authors.lastname: Pabby
authors.forename: Anupam
authors.initials: A
authors.lastname: Suneja
authors.forename: Timothy
authors.initials: T
authors.lastname: Heeren
authors.forename: Francis A
authors.initials: FA
authors.lastname: Farraye
mesh_terms: D000367:Age Factors; D000368:Aged; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D012812:Sigmoidoscopy / Q000009:adverse effects