Opinions vary on surveillance colonoscopy in older adults

National guidelines recommend surveillance colonoscopy at more frequent intervals after Adenoma removal as there is a higher risk of colorectal cancer among patients with adenomas. The benefit harm balance becomes uncertain as potential harms from the procedure increase with age from the procedure.

Overall Physicians were less likely to recommend surveillance colonoscopies if the patient was older , had poor health , and had lower risk adenomas. Health status had larger effects on decision making than adenoma risk .

In general, Family medicine and general practise physicians were most likely to recommend surveillance at 40 % and gastroenterologists were least likely to recommend surveillance at 30.9%.

Current guidelines on surveillance colonoscopies are solely based on prior adenoma characteristics. Guidelines need to incorporate guidance that considers patient age and health status, as well as adenoma risk and explicitly considers when surveillance should stop in older adults.