Schonberg Mara A, Breslau Erica S, Hamel Mary Beth, Bellizzi Keith M, McCarthy Ellen P
Division of General Medicine and Primary Care, Department of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
J Am Geriatr Soc. 2015 Apr;63(4):750-6. doi: 10.1111/jgs.13335.
To examine receipt of colorectal cancer (CRC) screening according to age and life expectancy (LE) in adults aged 65 and older.
Population-based survey.
United States.
Community dwelling adults aged 65 and older who participated in the 2008 or 2010 National Health Interview Survey (N = 7,747).
Receipt of CRC screening (e.g., colonoscopy within 10 years) was examined according to age and LE (≥10 and <10 years), adjusting for sociodemographic characteristics and survey year. Frequency of CRC screening was also examined according to age and LE at time of screening (e.g., age at colonoscopy rather than at interview). Participants screened when they were aged 75 and older or had less than a 10-year LE were considered to have received screening inconsistent with guidelines.
Overall, 38.5% of participants had less than a 10-year LE; 40.2% were aged 75 and older, and 56.3% had received recent CRC screening (90.1% by colonoscopy). CRC screening was higher in 2010 (58.9%) than 2008 (53.7%, P <.001) and was associated with longer LE and younger age, although 51.1% of adults aged 75 and older reported receiving CRC screening, as did 50.9% of adults with less than a 10-year LE. Based on age and LE at time of screening (rather than at interview), 28.4% of CRC screening of adults aged 65 and older was targeted to those aged 75 and older and those with less than a 10-year LE. Of adults aged 65 to 75 with a 10-year LE or more (adults recommended for screening by guidelines), 39.2% had not recently been screened.
Older adults with little chance of benefit because of limited LE commonly undergo CRC screening, whereas many adults aged 65 to 75 with a 10-year LE or greater are not screened.
根据年龄和预期寿命（LE），对65岁及以上成年人的结直肠癌（CRC）筛查接受情况进行研究。
基于人群的调查。
美国。
参与2008年或2010年全国健康访谈调查的65岁及以上社区居住成年人（N = 7747）。
根据年龄和预期寿命（≥10年和<10年）对CRC筛查接受情况（如10年内的结肠镜检查）进行研究，并对社会人口学特征和调查年份进行调整。还根据筛查时的年龄和预期寿命（如结肠镜检查时的年龄而非访谈时的年龄）对CRC筛查频率进行研究。在75岁及以上或预期寿命不足10年时接受筛查的参与者被视为接受了不符合指南的筛查。
总体而言，38.5%的参与者预期寿命不足10年；40.2%的参与者年龄在75岁及以上，56.3%的参与者最近接受了CRC筛查（90.1%通过结肠镜检查）。2010年的CRC筛查率（58.9%）高于2008年（53.7%，P <.001），且与更长的预期寿命和更年轻的年龄相关，尽管75岁及以上成年人中有51.1%报告接受了CRC筛查，预期寿命不足10年的成年人中这一比例为50.9%。根据筛查时（而非访谈时）的年龄和预期寿命，65岁及以上成年人的CRC筛查中有28.4%针对75岁及以上以及预期寿命不足10年的人群。在预期寿命为10年或更长的65至75岁成年人（指南推荐进行筛查的成年人）中，39.2%最近未接受筛查。
由于预期寿命有限而获益机会不大的老年人通常接受CRC筛查，而许多预期寿命为10年或更长的65至75岁成年人未接受筛查。
