Adenoma detection rates and complications of colonoscopy in patients aged 75 to 79 vs 70 to 74 years: Propensity score-matching study

Abstract Several guidelines recommend discontinuation of routine surveillance colonoscopy after age 75 years. Because Japan has one of the longest life expectancies, we considered ceasing at age 80 years. We compared patients aged 75 to 79 years with those aged 70 to 74 years, regarding adenoma detection rate (ADR), mean number of adenomas per colonoscopy, and adverse events. This propensity score-matching (PSM) study included patients aged 70 to 79 years with a performance status of 0 to 1 who underwent colonoscopies at Toyoshima Endoscopy Clinic between 2017 and 2024. Patients aged 75 to 79 years were matched with those aged 70 to 74 years for baseline characteristics using the propensity score. ADR, mean number of adenomas per colonoscopy, frequency of respiratory depression, hypotension, and delayed post-polypectomy bleeding were compared between the two groups. During the study period, 3415 patients were included. The ADR in patients aged 75 to 79 years was higher than that in patients aged 70 to 74 years (66.5% vs 62.2%, P = 0.021). Mean number of adenomas per colonoscopy in patients aged 75 to 79 years was higher than that in patients aged 70 to 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%). Colonoscopies for patients aged 75 to 79 are safe and effective in Japan.