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Shashideep Singhal 1,2 and Kinesh Changela 1 and Puneet Basi 1 and Siddharth Mathur 1 and Sridhar Reddy 1 and Mojdeh Momeni 1 and Mahesh Krishnaiah 1 and Sury Anand 1
Academic Editor:J. R. Monson and Academic Editor:S. Ogino
1, Division of Gastroenterology, Department of Internal Medicine, The Brooklyn Hospital Center, Brooklyn, NY 11205, USA
2, Digestive and Liver Diseases, Columbia University Medical Center, 5141 Broadway, New York, NY 10034, USA
Received 7 February 2014; Accepted 24 March 2014; 6 April 2014
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
1. Introduction
Colorectal cancer (CRC) is a significant cause of cancer related deaths in the USA. The United States Preventative Services Task Force (USPSTF) recommends that persons aged 50 and up be screened for colorectal cancer [1]. Currently, multiple societies have recommended colonoscopy as the gold standard test for prevention and early detection of colorectal cancer. Incidence of CRC has been shown to increase with advancing age and the decision to perform colonoscopy for CRC screening in the elderly should be based on multiple factors including comorbidities, individual's risk of cancer, and risks associated with the procedure [2]. The risks involved in undergoing a colonoscopy increase with advancing age and comorbidities [3]. There is an ongoing debate on the usefulness of colonoscopy in the elderly population due to limited life expectancy and possible harmful side effects such as adverse reactions to sedatives (particularly those patients with preexisting cardiovascular and/or pulmonary disease), colon perforation/bleeding, and dehydration associated with colon prep. FOBT, on the other hand, requires no sedation or bowel prep, while the patient experiences only minimal discomfort. Screening with FOBT has been demonstrated to reduce mortality from colorectal cancer in randomized trials [4].
Few screening trials have included the elderly patient population and none used FOBT as a prescreening tool prior to colonoscopy. This study was conducted to determine if using FOBT to select patients for colonoscopy can be a valuable approach for patients over the age of 75. The study focuses on comparing the advanced adenoma detection rate (ADR), the number of tubular adenomas detected,...