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Review
. 2025 Jun 2;27(1):34.
doi: 10.1007/s11894-025-00985-5.

Current Perspectives on Colorectal Cancer Screening and Surveillance in the Geriatric Population

Jahnavi Udaikumar  1 , Rithish Nimmagadda  2 , Sushrut Ingawale  3 , Vindhya Vasini Lella  4 , Keerthika Vijayakumar  5 , Adam S Faye  6 , Aasma Shaukat  7
Affiliations
Review

Current Perspectives on Colorectal Cancer Screening and Surveillance in the Geriatric Population

Jahnavi Udaikumar et al. Curr Gastroenterol Rep. .

Abstract

Purpose of review: Colorectal cancer (CRC) is a leading cause of cancer-related mortality, with 44% of deaths occurring in individuals aged 75 years and older. With 78 million adults over 65 years projected by 2035, optimizing CRC screening and surveillance is crucial. This review examines guidelines, risks, and personalized approaches.

Recent findings: CRC screening reduces incidence by 17-33% and mortality by 11-53%. Colonoscopy lowers mortality by 61% but has a 6.8% complication rate in those aged 75 years and older. The risk of gastrointestinal bleeding is 8.7 per 1,000 for polypectomy, and perforation occurs in 0.6 per 1,000. Frailty indices assess suitability, but surveillance guidelines lack clear discontinuation criteria. Screening should balance risk, complications, and health status. It may be cost-effective up to age 86 years in healthy individuals, but more research is needed to refine surveillance strategies and reduce overtreatment in older adults.

Keywords: Colorectal cancer; Elderly; Frailty indices; Geriatrics; Guidelines; Quality of life; Screening; Surveillance.

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Conflict of interest statement

Declarations. Ethics Declaration (Human and Animal Rights): This article does not contain any studies with human or animal subjects performed by any of the authors. Competing Interests: The authors declare no competing interests.

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