Subsequent colon cancer is rare in older patients with polyps

Clinical Question

What is the rate of development of colorectal cancer in older patients with colon polyps?

Bottom line

In a population of older patients (65 years and older) with colon polyps identified by colonoscopy, few — 0.2% — will develop colon cancer. It may be time to re-evaluate the current recommendations for 5-year surveillance in older patients with previously identified polyps, especially for patients with a calculated shorter life expectancy. (LOE = 1b)

Overuse alert: This POEM aligns with the Canadian Association of General Surgeons’ Choosing Wisely Canada recommendation: Avoid colorectal cancer screening tests in asymptomatic patients with a life expectancy of less than 10 years and with no personal or family history of colorectal neoplasia.

Study design: Cohort (prospective)

Funding: Government

Setting: Population-based

Reviewer

Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA


Discuss this POEM


Comments

Rachel Park

Polyps

What types of Polyps. Did this review look at the type and number ? Many people 65 and older have a life expectancy of over 10 years

Roland Michael Grad

2 per 1,000

Stopping cancer screening can be a challenge. This POEM will help my patients to better understand why continuing into advanced age is not recommended for most.

Arup Kumar Dhara

Impact assessment

Excellent

Anonymous

Misinformation

The choosing wisely comment refers to screening , not surveillance . Very different topic

Anonymous

COLON POLYP CONVERTING TO COLON CANCR IN OLDR PATIEN

GOOD TO KNOW

Anonymous

Reduce overuse of screening colonoscopy in older patients

Makes sense to lessen the risk and expense of colonoscopy in patients with life expectancy of less than 10 years.