Colonoscopy and colorectal cancer rates among octogenarians and nonagenarians: nationwide study of US veterans

BACKGROUND: According to Surveillance, Epidemiology and End Results (SEER) database, colorectal cancer (CRC) is the fourth most common type of cancer and second highest in cancer-related death after lung cancer. The SEER database is geographically limited, currently present in only 10–12 states. Though this gives a good approximation about the overall direction of CRC incidence and prevalence, we need more nationwide data to compare numbers. Furthermore, colonoscopies and CRC rates in the Veterans Affair (VA) geriatric population have not been studied. OBJECTIVES AND METHODS: Our aim was to study the rate of colonoscopies and CRC in octogenarians and nonagenarians and to find the prevalence of CRC in this population. The goal was to obtain data in this subset of patients in order to further expand CRC screening guidelines. A retrospective data analysis was performed consisting of US male veterans who underwent colonoscopy in the VA Health Care System from 2000 to 2015. RESULTS AND CONCLUSION: A total of 458,224 patients aged ≥80 years were identified from the database between years 2000 and 2015. This was divided into three groups of age 80–84 years (89,621 patients), 85–90 years (248,155 patients), and >90 years (120,448 patients). A total of 81,946 patients underwent colonoscopies of which 9,365 were diagnosed with CRC. There was a statistically significant linear increase in rate of colonoscopies with increase in age suggesting that these veterans who end up living to a higher age eventually get a colonoscopy for one reason or the other. The drop in CRC percentage and prevalence observed in age group 85–90 years is statistically different when compared to that in 80–84 years and >90 years groups; however, its clinical significance remains to be elucidated.