Colonoscopy Benefits Last Longer Than Thought

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What's more, the duration of the interval of decreased colorectal cancer risk persisted for more than 10 years. The Canadian team did not call for a change in the recommended interval, but did say the "findings suggest that screening colonoscopies do not need to be performed at intervals shorter than 10 years."

The Seattle study took a similar look at 1,244 people who underwent colonoscopies, in three age groups: 50 to 54, 75 to 79, and 80 and older.

The incidence of the cancer was much higher in the oldest participants -- 14 percent for the 80-and-up group -- compared to 3.2 percent for the 50-to-54 group. However, the benefit in terms of extended lifespan from colonoscopy was very small for the oldest group -- about 45 days, compared to more than 10 months for those aged 50 to 54.

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The results "suggest that the benefit of screening colonoscopy in very elderly patients may be smaller than what is commonly believed," the researchers wrote. They add that the information might "help avoid its use in patients who are unlikely to benefit substantively."

Neither study is definitive, Church said. He agreed that the Canadian finding "doesn't give us any reason to change the currently recommended interval of 10 years. It does leave open the possibility that an even longer interval might be possible."

On the other hand, he said, the Seattle study "raises a legitimate question: What should be the determination of when you no longer screen for colorectal cancer?"

Any answer would involve more factors than simply age and colonoscopy frequency, he said. Other, less uncomfortable screening techniques, such as fecal blood tests and flexible sigmoidoscopy, are known to be effective, Church said.

"The decision needs to be based not strictly on age, but the health of the individual," he said. "Some older people are in good shape and will live for 20 years or more. Others have multiple health problems, their hearts or other organs may be failing. They are likely to die of something other than colorectal cancer, so we definitely need to take into account what a person's health status is before making a screening decision."

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