Problems in screening colorectal cancer in the elderly

AIM:To explore the problems in the screening of colorectacarcinoma in the elderly.METHODS:Three models of colorectal cancer preventionwere examined:standard screening,active check-up ofsuspected cases and summons to have endoscopic check-up for previously diagnosed colorectal polyps.The studywas performed among three groups of elderly individuals:Group 1 (167 cases),hospitalized asymptomatic individualswithout symptoms in large intestines.Group 2 (612 cases):old individuals at home for the aged,out of which 32 showedsymptoms of colon disorders;Group 3 (44 cases):elderlypeople with diagnosed polyps.As a result of 1788rectosigmoidoscopies,we identified 61 individuals withpolyps,out of which 44 patients were over 65 years old.However,only 9 of these 44 individuals agreed to have theendoscopy performed again.RESULTS:One cancer and 13 polyps were detected inGroup 1,and two polyps in Group 2.However,it should benoted that only eleven individuals from Group 2 agreed tohave the endoscopy.In Group 3,there were no relapses ofthe polyps among the nine individuals who came back forthe endoscopy.CONCLUSION:Poor understanding of the screeningprocedures is one of the greatest problems in early detectionof the cancer in the aged.Paradoxically,the cooperation isbetter with hospitalized patients,than with "successfully old"persons.