The necessity of colorectal cancer screening for elderly patients

In association with the growing elderly population, the rates of colorectal cancer are increasing worldwide. Thus, the need for total colonoscopy in the elderly can be expected to increase accordingly with this trend. The World Health Organization defines the “elderly” as people ≥65 years of age. Meanwhile, the global life expectancy is approximately 70 years of age, and it is closer to 80 years in certain countries. However, even among the elderly, it is difficult to imagine that patients 65–74 years of age and those ≥75 years of age are similar in terms of their physical function. Furthermore, the incidence of various underlying diseases is much higher in the elderly than that in younger individuals. This must be considered while performing highly invasive total colonoscopy. A procedural accident during this type of treatment may be fatal in the elderly, as they have reduced organ reserve capacities. As such, the use of total colonoscopy remains a subject of debate and requires further investigation. In particular, we need to evaluate whether an endoscopy for colorectal cancer screening should be performed for all elderly individuals.