Curriculum · Elderly / Community care
When to stop cancer screening in older adults
What it is
Cancer screening in an older adult does not stop at one fixed age. National guidelines vary, but it is generally advised to start routine colon cancer screening between ages 45 and 50, and to screen with a more individualized approach between ages 75 and 85. The upper band is therefore not a fixed stopping age but a point at which the decision moves from the guideline to the individual patient.
Causes and risk
Screening for colorectal cancer is recommended for average-risk individuals beginning at age 50 (SOR A). Individuals at higher risk include those with a personal history of adenomatous polyps, colorectal cancer, inflammatory bowel disease, genetic cancer syndromes, or a family history of either adenomatous polyps or colorectal cancer. Patients with a first degree relative affected before age 60, or two or more first degree relatives affected at any age, begin colonoscopy screening at age 40 or 10 years before the youngest age a family member was diagnosed, whichever comes first, and are followed at a maximum surveillance interval of 5 years (SOR C). The band below that is different: patients with a single first degree relative diagnosed at age 60 or older, and patients with two affected second degree relatives, undergo screening starting at age 40 by any recommended method, and at the same intervals as for average-risk individuals (SOR C).