Understanding the Older Patient Perspective on Colorectal Cancer Screening Cessation

Clinical practice guideline agencies in the US uniformly recommend that older adults continue colorectal cancer (CRC) screening until 75 years of age. For adults aged 76 to 85 years, most guidelines indicate that the decision to continue screening, and what modality to use, should be based on a careful discussion of the risks and benefits of screening, as well as the overall health of the patient. However, implementation of these guidelines in primary care settings has challenges, such as the elicitation of the patient’s preference about stopping or continuing CRC screening. Brotzman et al used data from a nationally representative survey of older adults to attempt to answer this question of how patients may react to a recommendation to stop CRC screening at age 75. They used data from the Health and Retirement Study, a biennial longitudinal cohort study of US adults 50 years and older. Participants received the following question: “Guidelines recommend that patients stop getting screened for colon cancer once they reach age 75. This is because for many healthy patients aged 75 and older, the harms of testing may be greater than the benefits of finding a new cancer. How acceptable is this recommendation to you personally?” Nearly 40% of respondents stated that these guidelines were somewhat or very unacceptable, and the respondents had similar reactions whether they had a long (≥10 years) or limited (<10 years) life expectancy.