Background: Several guidelines recommend the discontinuation of routine surveillance colonoscopy after the age of 75 years. Since Japan has one of the longest life expectancies, we considered ceasing at the age of 80 years. We compared patients aged 75-79 years with those aged 70-74 years, regarding adenoma detection rate, the mean number of adenomas per colonoscopy, and adverse events. Methods: This propensity-score matching study included patients aged 70-79 with a performance status of 0-1 who underwent colonoscopies at Toyoshima Endoscopy Clinic between 2017 and 2024. Patients aged 75-79 years were matched with those aged 70-74 years for baseline characteristics using the propensity score. Adenoma detection rate, the mean number of adenomas per colonoscopy, frequency of respiratory depression, hypotension and delayed post-polypectomy bleeding were compared between the two groups. Results: During the study period, 3415 patients were included. The adenoma detection rate in patients aged 75-79 years was higher than that in patients aged 70-74 years (66.5% vs 62.2%, P = 0.021). The mean number of adenomas per colonoscopy in patients aged 75-79 years was higher than that in patients aged 70-74 years (1.54 vs 1.38, P = 0.014). The two groups did not show significant differences in respiratory depression (2.6% vs 2.3%), hypotension (0.8% vs 1.0%) or delayed post-polypectomy bleeding (0.2% vs 0.4%). Conclusion: Colonoscopies for patients aged 75-79 are safe and effective in Japan.
Toyoshima et al. (2026) studied this question.