title: Colorectal cancer screening and surveillance in the elderly: updates and controversies.
abstract: Colorectal cancer is common worldwide, and the elderly are disproportionately affected. Increasing age is a risk factor for the development of precancerous adenomas and colorectal cancer, thus raising the issue of screening and surveillance in older patients. Elderly patients are a diverse and heteroge-neous group, and special considerations such as comorbid medical conditions, functional status and cognitive ability play a role in deciding on the utility of screening and sur-veillance. Colorectal cancer screening can be beneficial to patients, but at certain ages and under some circumstances the harm of screening outweighs the benefits. Increasing ad-verse events, poorer bowel preparation and more incomplete examinations are observed in older patients undergoing colo-noscopy for diagnostic, screening and surveillance purposes. Decisions regarding screening, surveillance and treatment for colorectal cancer require a multidisciplinary approach that accounts not only for the patient's age but also for their overall health, preferences and functional status. This review provides an update and examines the challenges surround-ing colorectal cancer diagnosis, screening, and treatment in the elderly.
authors.affiliation: Division of Gastroenterology, Department of Medicine, San Francisco General Hospital and Trauma Center CA, USA.
authors.forename: Lukejohn W
authors.initials: LW
authors.lastname: Day
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of California, San Francisco, CA, USA.
authors.forename: Fernando
authors.initials: F
authors.lastname: Velayos
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer; D006801:Humans; D008403:Mass Screening; D008875:Middle Aged
keywords: Colonoscopy; Colorectal neoplasms; Elderly; Screening; Surveillance