Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

Endoscopist Specialty & CRC Screening in Older Adults

Am J Gastroenterol; ePub 2018 Nov 2; Calderwood, et al

Among older adults who underwent normal screening colonoscopy exams, the majority were told to return for future screening colonoscopy, a recent study found. Researchers included normal screening colonoscopy exams in adults aged ≥50 years within the New Hampshire Colonoscopy Registry between 2009 and 2014. The primary outcome was endoscopists’ recommendation against further screening. The main exposure variables included patient age, family history of CRC, and endoscopist characteristics. Among the findings:

  • Of 13,364 normal screening colonoscopy exams, 2,914 (21.8%) were in adults aged ≥65 years and were performed by 74 endoscopists.
  • Nearly 100% of adults aged 65‒69 years undergoing screening colonoscopy were given the recommendation to return for future screenings.
  • Only 15% of average-risk patients aged 70‒74 years were told to stop receiving screening.
  • Having a family history of CRC or a non-gastroenterology endoscopist increased the likelihood of being told to return for screening at advanced ages.


Calderwood AH, Anderson JC, Robinson CM, Butterly LF. Endoscopist specialty predicts the likelihood of recommending cessation of colorectal cancer screening in older adults. [Published online ahead of print November 2, 2018]. Am J Gastroenterol. doi:10.1038/s41395-018-0406-z.