Assessing Colorectal Cancer and Mortality Risk in Older Adults
Menée à partir de données portant sur 91 952 personnes (âge médian : 71 ans ; 98 % d'hommes ; durée de suivi : 10 ans), cette étude examine, en fonction de la présence d'un adénome à la dernière coloscopie, le risque de cancer colorectal et le risque de décès chez les adultes âgés de 75 ans ou plus
Colonoscopy is one of the most effective cancer prevention interventions developed in the last half-century. The long-term protective effect of colonoscopy has been validated in many well-designed studies. For individuals of screening age, a colonoscopy without adenomas reflects a lower risk of incident and fatal colorectal cancer (CRC) for at least 10 years and potentially up to 20 years.Even a once-only sigmoidoscopy confers protection for up to 17 years. The landmark National Polyp Study showed that while adenomas confer an increased risk of CRC, polypectomy markedly reduces CRC incidence and mortality. Although individuals with adenomas found on colonoscopy are considered to be in a higher-risk group, the removal of nonadvanced adenomas has been associated with risk reductions in CRC that are similar to individuals without adenomas. These studies generally included individuals 50 years of age or older, but as the population ages and accumulates comorbid conditions, the relative merit of performing surveillance colonoscopy specifically in older individuals gets called into question.
JAMA , éditorial, 2026