The researchers followed 144,768 men and women, between the ages of 55 and 74, over the course of 13 years. The goal was to determine colon cancer risk in those with a family history of colon cancer by at least a first degree relative.
Those with an average risk are advised to undergo a colonoscopy every 10 years after the age of 50. Those who have a first degree relative who had colon cancer and are younger than 60, or who have two relatives with colon cancer at any age, are recommended to undergo a colonoscopy every five years, beginning at the age of 40 or 10 years prior to the age their youngest relative was diagnosed with colon cancer. Screening is usually recommended to stop between 75 to 85 years of age, but it has been unclear if this is useful or not.
Co-author of the editorial Chyke A. Doubeni said, “The accumulated evidence shows that the risk of a colorectal cancer diagnosis in patients associated with having a family history of the condition becomes progressively smaller with increasing age, as does the association between family history and death from colorectal cancer. Current standards recommend aggressive screening until age 75 to 85, but now a growing body of evidence show that it is not necessary to continue to screen most older people with a family history that aggressively.”
Doubeni recommends that for those over 55, especially 65 and over, screening should be similar to those with an average risk. Those with two or more relatives with colon cancer should receive the same testing as those at high risk – every five years.
The editorial was published in Gastroenterology.