Many older adults feel they should continue getting screened for colon cancer even after turning 75, according to a study published in the journal JAMA Network Open. The study found that 40% of adults over 50 surveyed believe that stopping routine colon cancer screenings at age 75 is not acceptable.
Colon cancer, which falls under the broader category of colorectal cancer, starts in the colon or rectum. Health guidelines recommend regular screenings, like colonoscopies, starting between ages 45 and 50 for people with average risk, as this helps catch potential issues early when they are usually more treatable.
However, experts say that by age 75, the risks of screening often outweigh the benefits. This is why the U.S. Preventive Services Task Force advises personalized screening decisions starting at 75 and recommends stopping screenings altogether by age 85. The American College of Physicians suggests that routine screenings should end at age 75 for those at average risk who don’t show symptoms and have a life expectancy of no more than 10 years.
Despite these recommendations, the new study suggests many older adults are not on board with the age cutoff, even though colon and rectal cancers combined are the second leading cause of cancer deaths in the U.S.
Study co-author Brian J. Zikmund-Fisher emphasized that many older adults remain skeptical about recommendations to stop screenings like colonoscopies. He noted that for some, continued screenings could be more harmful than beneficial, and there’s a need for open, honest conversations about this with older adults.
The research analyzed responses from 1,302 participants in the Health and Retirement Study, involving U.S. adults aged 50 and older. Of these, 794 were women and 508 men, with 23% having a limited life expectancy according to the Lee Index.
Participants were asked whether stopping screenings after age 75 due to potential risks was acceptable or not. Results showed that 60% found the guidelines either acceptable or somewhat acceptable, while nearly 40% found them unacceptable.
Interestingly, life expectancy didn’t significantly sway opinions—about 39% of both those with limited and longer life expectancies disagreed with the guidelines.
Laura Brotzman, a study co-author, noted that in interviews, some older adults believed that the screening age limits are cost-saving measures that limit individual choices. They often feel that the benefits of screening outweigh the potential risks and express concerns about life expectancy estimates being used to deny screenings.
Experts pointed out that routine procedures like colonoscopies still have risks, such as causing bleeding or intestinal tears, especially for those over 75, and even more so over 85. People in this age group are more likely to die from other causes, like heart disease or other cancers, according to Philip A. Philip, a director at the Henry Ford Cancer Institute.
One study highlighted that the chance of dying from other causes was over 100 times greater than from colorectal cancer for those aged 76 to 85 with a negative stool-based screening test. Therefore, focusing only on colorectal cancer as a cause of death is not realistic for those over 75, as the chances of having other life-threatening conditions are higher.
Just being over 75 doesn’t mean you shouldn’t consider colorectal cancer screening. It’s important to talk with your doctor about whether it makes sense for your specific health situation. Honest discussions about your overall health and potential benefit from screening are essential.
Doctors are likely to take into account both your life expectancy and health status when considering screening. Life expectancy is increasingly seen as a more nuanced factor than age alone for deciding on cancer screenings for older adults. Your screening history is also important; those up-to-date with screenings are more likely to die from other causes than colorectal cancer, whereas those not consistently screened might benefit more from screening after 75.
