When should screening colonoscopy not be offered or surveillance stopped?
- Evidence suggests that the risks of colonoscopy increases with advancing age.
- Surveillance and screening should not be continued when risks outweigh the benefits.
- The United States Preventive Services Task Force (USPSTF) determined that screening should not be continued after age 85 years because the risk could exceed potential benefit.
- For patients aged 75 to 85 years, the USPSTF recommends against continued routine screening but argues for individualization based on comorbidities and findings of any prior colonoscopy.
- Patients with HRA are at higher risk for developing advanced neoplasia compared with average-risk patients and therefore the potential benefit of surveillance could be higher than for screening in these individuals.
