Vol. 19 No. 1 (2021)
Brief Report

Assessing the appropriateness of colorectal cancer screening in very elderly women: A cross-sectional analysis

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  • Jérôme Williams,
  • Zhou Fang,
  • Roland Grad
Jérôme Williams
McGill University Faculty of Medicine
Bio
Zhou Fang
McGill University Faculty of Medicine
Bio
Roland Grad
McGill University Faculty of Medicine
Bio
woman in white coat reaching into medical cabinet
DOI: https://doi.org/10.26443/mjm.v19i1.339

Published 2021-03-03

Keywords

  • Overscreening,
  • Choosing Wisely,
  • Low-value Care,
  • Colorectal Cancer,
  • Screening

How to Cite

1.
Williams J, Fang Z, Grad R. Assessing the appropriateness of colorectal cancer screening in very elderly women: A cross-sectional analysis. McGill J Med [Internet]. 2021 Mar. 3 [cited 2025 Oct. 30];19(1). Available from: https://mjm.mcgill.ca/article/view/339

Copyright (c) 2021 Jérôme Williams, Zhou Fang, Roland Grad

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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Abstract

The Canadian Task Force on Preventive Health Care recommends against screening for colorectal cancer after age 75. This recommendation is based in part on lag time to mortality benefit and a reduced life expectancy in the very elderly. To explore the extent to which screening for colorectal cancer is appropriately ordered in primary care, we performed a cross sectional study in women aged 80-84 at an academic family medicine clinic in Montreal. Appropriateness was assessed using a validated life expectancy calculator, with a 10-year life expectancy of >50% serving as the threshold for appropriateness. Among women 80-84 years of age under the care of a physician in 2016 (N=144), 95 fecal immunochemical tests were ordered from 2016-2019. Of these, 41 were screening tests, and 16/41 (39%; 95% CI 24% to 54%) were deemed to be inappropriate. This finding suggests a need to improve screening decisions for elderly women followed in primary care.

 

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