We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Comment & Response | Health Care Reform

Selection of Elderly Patients for Colorectal Cancer Screening

Shashideep Singhal, MD1; Kinesh Changela, MD2
[+] Author Affiliations
1Division of Gastroenterology, Hepatology & Nutrition, The University of Texas, Houston
2The Brooklyn Hospital Center, Brooklyn, New York
JAMA Intern Med. 2015;175(5):860. doi:10.1001/jamainternmed.2015.0341.
Text Size: A A A
Published online


To the Editor We read with interest the retrospective cohort study by Tran et al1 that describes the diagnostic yield of colonoscopy as a surveillance tool in elderly patients with a personal history of colorectal cancer (CRC) or precancerous polyps. The study reported a low incidence of CRC and higher complication rate in the elderly population compared with the reference group.

Using an institution-based registry involving minority population, we found a fairly high incidence of CRC in the elderly population (2.32%) (mean age, 77.78 years).2 The safety of colonoscopy in elderly patients has been a topic of debate. In our experience, and in many other published studies, colonoscopy has been shown to be safe in the elderly population.3 In our study,3 CRC detection rate was significantly higher in elderly patients who presented with symptoms such as hematochezia or anemia compared with the screening group. This highlights the importance of colonoscopy in a symptomatic elderly population, which can help in diagnosis of CRC at an early stage. In another study,4 we have investigated the impact of comorbidities on the decision regarding the use of CRC screening in the elderly population. We found that 50% patients diagnosed as having colon cancer had a life expectancy of more than 5 years. This suggests that life expectancy based on comorbidity profile and age should be taken into consideration when making a decision regarding the use of CRC screening in elderly patients.4


Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





May 1, 2015
Paul F. Pinsky, PhD; Robert E. Schoen, MD, MPH
1Division of Cancer Prevention, National Cancer Institute, Bethesda, Maryland
2Department of Gastroenterology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
JAMA Intern Med. 2015;175(5):858-860. doi:10.1001/jamainternmed.2015.0344.
May 1, 2015
Bechien U. Wu, MD, MPH
1Center for Digestive Health Research, Division of Gastroenterology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
JAMA Intern Med. 2015;175(5):860-861. doi:10.1001/jamainternmed.2015.0347.
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

0 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...