by Lori Solomon

Personalized colorectal cancer (CRC) screening based on individual life expectancy may increase the value of CRC screening programs, according to a study published online Oct. 27 in the American Journal of Gastroenterology.

Po-Hong Liu, M.D., from the University of Texas Southwestern Medical Center in Dallas, and colleagues examined receipt of past-year CRC screening according to predicted 10-year mortality risk among 25,888 community-dwelling, older adults (ages 65 to 84 years) who were not up-to-date with screening.

The researchers found that the prevalence of past-year CRC screening was 39.5, 40.6, 38.7, 36.4, and 35.4 percent from the lowest to highest quintile of 10-year mortality risk. There were no significant differences observed in the odds of CRC screening between adults in the lowest versus highest quintile (adjusted odds ratio, 1.05; 95 percent confidence interval, 0.93 to 1.20).

More than one-quarter (27.9 percent) of past-year CRC screening occurred in adults with life expectancy <10 years. Furthermore, at the time of screening, more than half of adults aged 75 to 84 years (50.7 percent) had 10-year mortality risk ≥50 percent.

"An age-based approach to CRC screening results in underscreening of older, healthier adults and overscreening of younger adults with chronic conditions," the authors write.

One author disclosed ties to Exact Sciences, Universal Dx, Roche, and Freenome.

More information: Po-Hong Liu et al, Colorectal Cancer Screening Receipt Does Not Differ by 10-Year Mortality Risk Among Older Adults, American Journal of Gastroenterology (2023). DOI: 10.14309/ajg.0000000000002536

Journal information: American Journal of Gastroenterology 

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