Influence of Age and Comorbidity on Colorectal Cancer Screening in the Elderly

Introduction Expert recommendations differ for colorectal cancer screening in the elderly. Recent studies suggest that healthy adults aged >75 years may benefit from screening. This study examined screening use and follow-up, and how they varied by health status within age strata, among a large c...

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Bibliographic Details
Published in:American journal of preventive medicine 2016-09, Vol.51 (3), p.e67-e75
Main Authors: Klabunde, Carrie N., PhD, Zheng, Yingye, PhD, Quinn, Virginia P., PhD, Beaber, Elisabeth F., PhD, Rutter, Carolyn M., PhD, Halm, Ethan A., MD, MPH, Chubak, Jessica, PhD, Doubeni, Chyke A., MD, MPH, Haas, Jennifer S., MD, MSc, Kamineni, Aruna, PhD, Schapira, Marilyn M., MD, MPH, Vacek, Pamela M., PhD, Garcia, Michael P., MS, Corley, Douglas A., MD, PhD
Format: Article
Language:English
Subjects:
Age Factors
Aged
Aged, 80 and over
California
Cohort Studies
Colonoscopy - statistics & numerical data
Colorectal Neoplasms - diagnosis
Comorbidity - trends
Early Detection of Cancer - methods
Female
Humans
Internal Medicine
Longitudinal Studies
Male
Mass Screening - statistics & numerical data
Occult Blood
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Summary:Introduction Expert recommendations differ for colorectal cancer screening in the elderly. Recent studies suggest that healthy adults aged >75 years may benefit from screening. This study examined screening use and follow-up, and how they varied by health status within age strata, among a large cohort of elderly individuals in community settings. Methods A population-based, longitudinal cohort study was conducted among health plan members aged 65–89 years enrolled during 2011–2012 in three integrated healthcare systems participating in the Population-Based Research Optimizing Screening through Personalized Regimens consortium. Comorbidity measurements used the Charlson index. Analyses, conducted in 2015, comprised descriptive statistics and multivariable modeling that estimated age by comorbidity–specific percentages of patients for two outcomes: colorectal cancer screening uptake and follow-up of abnormal fecal blood tests. Results Among 846,267 patients, 72% were up-to-date with colorectal cancer screening. Of patients with a positive fecal blood test, 65% received follow-up colonoscopy within 3 months. Likelihood of being up-to-date and receiving timely follow-up was significantly lower for patients aged ≥76 years than their younger counterparts ( p
ISSN:0749-3797
1873-2607
DOI:10.1016/j.amepre.2016.04.018